Medical Education

Clerkship / Post-Clerkship

The clerkship and post-clerkship years provide students with an immersive, firsthand experience as physicians-in-training at Brown's affiliated hospitals.

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Clerkship / Post-Clerkship

The clerkship and post-clerkship years provide students with an immersive, firsthand experience as physicians-in-training at Brown's affiliated hospitals.

Beginning in Year 3, clerkships immerse students in the experiences associated with a particular field of medicine. Students work full-time at a designated site during each six-, eight-, and twelve-week rotation period and are assigned on-call duty on scheduled nights and weekends.

There are also a variety of elective opportunities at our affiliated hospitals or at other approved institutions, as well as the option to pursue an independent study.

Clinical Requirements

Students must complete a minimum of 80 weeks of clinical training throughout Years 3 and 4, 68 weeks of which must be taken at The Warren Alpert Medical School of Brown University, including the following:

Core Clerkships

Students must complete 44 weeks of clerkships in the specialties listed below for academic year 2024-2025.

The Internal Medicine Clerkship is a 12-week clerkship experience, in which students spend time in both an inpatient and outpatient setting. In the inpatient setting, students will be assigned to the medicine teaching service, in which they will admit and follow patients who are acutely ill. In the outpatient setting, students will work with general and specialty internists on a range of diagnoses common to Internal Medicine. Students will also participate in a range of didactic sessions on this clerkship, including teaching around electrocardiograms, radiology and small groups focused on important issues in Internal Medicine.

Assessment Methods	Grade Composition
Written Clinical Evaluations	50%
OSCE	25%
Shelf Exam	15%
Clinical Pathological Conference Submission	5%
History & Physical	5%

Objectives

Describe the clinical features, differential diagnosis, work-up and management of common inpatient and outpatient medical conditions.
Complete a patient’s history and physical examination in an organized and thorough manner.
Order laboratory tests and radiologic studies, taking into account the appropriate evidence-based medicine and stewardship of resources.
Formulate a differential diagnosis based on a patient’s history, prioritizing the most likely diagnoses.
Devise an initial treatment plan for a patient, based on the available data, including a patient’s history, physical examination, and laboratory and radiology studies.
Effectively communicate, both verbally and in writing, with patients and other health professionals around a patient’s illness.
Identify gaps in knowledge and use available online resources to address those gaps.
Work collaboratively with other healthcare professionals, including nurses, pharmacists, social workers, physical therapists and unit secretaries around the care of patients.
Integrate health maintenance into patient encounters when appropriate.
Use ethical principles in the care of patients.

Clerkship Log

Students must meet minimal, quantifiable criteria for successful completion of the core clerkship in medicine at The Warren Alpert Medical School of Brown University. The experiences listed below define these criteria.

Please note: simulated patients/alternative experiences are available via didactics. Please discuss with the Clerkship Director.


Students must do the following checklist items (includes student responsibility and setting)	Minimum No. Required	Type of Patient
Evaluate/help manage abdominal pain in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage anemia in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage gastrointestinal bleeding in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage chronic liver disease in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage altered mental status in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage chest pain in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage heart failure in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage COPD in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage pneumonia in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage renal insufficiency (acute or chronic) in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage skin and soft tissue infection in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage syncope/presyncope in inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage thromboembolic disease in the inpatient or outpatient setting	2	Real, Simulated
Evaluate/help manage type 2 DM in the inpatient or outpatient setting	2	Real, Simulated
Attend interdisciplinary rounds in the inpatient or outpatient setting [student responsibility: perform]	1	Real
Interpret CXR in the inpatient or outpatient setting [student responsibility: perform]	5	Real
Interpret EKG in the inpatient or outpatient setting [student responsibility: perform]	5	Real
Complete (Perform) a My Life My Story narrative medicine project (inpatient or outpatient setting)	1	Real
Perform an examination observed by preceptor or supervisor in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real
Obtain/Perform a patient history observed by preceptor or supervisor in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real

The Surgery Clerkship is a six-week clerkship experience, in which students spend time primarily in an inpatient setting, working with surgery residents and attending physicians, on the surgical management of disease. Students will round with their assigned surgery team on a daily basis and then spend time in the operating room with both residents and attending physicians. In addition, students are assigned to an outpatient surgical attending preceptor, in which students will assist in the outpatient management of surgical disease. Finally, students will spend time in didactics, led by surgery attending and resident physicians as part of the clerkship.

Assessment Methods	Grade Composition
Written Clinical Evaluations	50%
OSCE	25%
Shelf Exam	20%
Other Assignments	5%

Objectives

Evaluate and manage surgical problems across a spectrum of adult patients representative of the RI community.
Evaluate and manage normal and abnormal surgical recovery.
Participate in operative procedures, including demonstration of basic technical skills.
Describe general attributes as a career as a surgeon through experiencing operating room culture.
Demonstrate patient safety protocols, including universal protocol.
Work collaboratively with other healthcare professionals, including nurses, pharmacists, social workers, physical therapists, physicians assistants, nurse practitioners, and administrative staff to support the care of patients.
Communicate effectively with patients and their families around surgical issues.

Clerkship Log

Students must meet minimal, quantifiable criteria for successful completion of the Surgery Clerkship at The Warren Alpert Medical School of Brown University. The experiences listed below define these criteria.

Please note: WISE-MD can be used for simulated patient/alternative experiences to fulfill these requirements if they are not met in the clinical setting. Please discuss with the Clerkship Director.

Students must do the following checklist items (includes student responsibility and setting)	Minimum No. of Times	Type of Patient
Assist in performing abdominal surgery for GI system & solid organs in the operating room	5	Real, Simulated
Assist in performing breast/skin & soft tissue / endocrine surgery in the operating room procedure room, or emergency department	3	Real, Simulated
Assist in performing hernia surgery in the operating room	3	Real, Simulated
Assist in performing emergency care (trauma, ICU, emergency operation or admission) in the operating room, emergency department, or inpatient setting	3	Real
Assist in performing wound management in the inpatient, outpatient, or emergency department settings	1	Real
Perform suturing under supervision in the operating room, procedure room, or emergency department	3	Real
Assist with management of NG tube in the emergency department or inpatient setting	1	Real, Simulated
Assist with management of an outpatient visit	3	Real
Perform a digital rectal exam in the inpatient or outpatient setting	1	Real, Simulated
Perform a focused history (observed by preceptor or supervisor) in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real
Perform a focused physical exam (observed by preceptor or supervisor) in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real

The Obstetrics and Gynecology Clerkship is a six-week clerkship, in which students work on a number of different services in caring for women’s health. Students will spend two weeks on Labor and Delivery working with attending and resident physicians, along with mid-wives in managing labor. Students will also spend two weeks with attending and resident physicians in gynecology surgery, caring for the surgical needs of women. Students will spend one week on night float, caring for a wide variety of issues affecting women, including spending time in the Emergency Department. Students will also spend one week in specialty clinics. Finally, students will participate in a didactic curriculum focused on the healthcare needs of women.

Assessment Methods	Grade Composition
Evaluations	50%
Shelf Exam	25%
OSCE	15%
Small Group	10%

Objectives

Gather an accurate, thorough and culturally appropriate history from a patient presenting with common obstetric and gynecologic complaints.
Perform a focused, pertinent physical examination for common presentations in Obstetrics and Gynecology.
Formulate an appropriate differential diagnosis and initial diagnostic and therapeutic plan (considering patient preference and safety) for patients presenting in Obstetrics and Gynecology.
Organize and succinctly summarize information from a patient encounter in an oral presentation and progress note.
Apply principles of health promotion and disease prevention to the care of patients.
Describe normal laboratory values in the care of patients presenting to an Obstetrics and Gynecology setting.
Perform basic procedures such as suturing, interpretation of fetal heart monitoring, vaginal births, pelvic and breast examinations.
Describe the role of an Obstetrician Gynecologist within the health care system.
Reflect on encounters with patients, faculty and colleagues to understand the role of biases and to improve patient care.
Use ethical principles in the care of patients.

Clerkship Log

Students must meet minimal, quantifiable criteria for successful completion of the core clerkship in Obstetrics and Gynecology at The Warren Alpert Medical School of Brown University. The experiences listed below define these criteria. An individual patient may fall into more than one category.

Please note: simulated patients/alternative experiences are available via APGO and UWise educational series. Please discuss with the Clerkship Director.

Students must do the following checklist items (includes student responsibility and setting)	Minimum No. of Times	Type of Patient
Evaluate/help manage endometriosis in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage pelvic pain in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage abnormal uterine bleeding in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage an ectopic pregnancy in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage a STD/PID in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage perimenopause/menopause in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage infertility in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage an adnexal mass in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage prolapse/incontinence in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage abnormal cervical cytology in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage vulvar/vaginal benign disease in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage fibroids in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage post-operative complications in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage first trimester bleeding in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage third trimester bleeding in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage PROM in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage HTN in pregnancy/preeclampsia in the inpatient or outpatient setting	1	Real
Evaluate/help manage fetal growth abnormalities in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage preterm labor in the inpatient or outpatient setting	1	Real
Evaluate/help manage a postpartum hemorrhage in the inpatient or outpatient setting	1	Real, Simulated
Evaluate teen pregnancy in the inpatient or outpatient setting	1	Real, Simulated
Evaluate/help manage routine prenatal care follow-up in the outpatient setting	1	Real, Simulated
Perform/assist in performing unintended pregnancy counseling in the inpatient or outpatient setting	1	Real, Simulated
Perform/assist in performing bimanual & speculum pelvic exam in the inpatient or outpatient setting	3	Real
Perform/assist in performing a breast exam in the inpatient or outpatient setting	1	Real
Perform/assist in performing a pap smear in the inpatient or outpatient setting	1	Real
Perform/assist in performing a wet prep/KOH/dry mount in inpatient or outpatient setting	1	Real, Simulated
Assist in performing a labor cervical exam in the inpatient or outpatient setting	1	Real
Perform/assist in performing postpartum depression screening in the inpatient or outpatient setting	1	Real, Simulated
Perform/assist in performing a laparoscopy in the inpatient setting	1	Real
Perform/assist in performing a hysteroscopy and/or dilation and uterine curettage in the inpatient setting	1	Real
Perform/assist in performing the insertion of a foley catheter in the inpatient setting	2	Real
Perform or assist in performing bedside ultrasound in the inpatient or outpatient setting	1	Real, Simulated
Assist in performing perineal repair in the inpatient setting	1	Real, Simulated
Assist in performing a C-section in the inpatient setting	2	Real
Assist in performing a hysterectomy in the inpatient setting	1	Real
Perform first trimester care in the outpatient setting	1	Real, Simulated
Perform a domestic violence screen in the inpatient or outpatient setting	1	Real, Simulated
Perform taking a sexual history in the inpatient or outpatient setting	1	Real, Simulated
Perform contraceptive counseling in the inpatient or outpatient setting	1	Real, Simulated
Demonstrate/Perform knot tying in the inpatient setting	1	Real
Demonstrate/Perform basic suturing in the inpatient setting	1	Real, Simulated
Demonstrate/Perform sterile technique in the inpatient or outpatient setting	1	Real
Follow the clinical course of labor in the inpatient setting [student responsibility: observe]	1	Real
Demonstration of assisting the basic steps of vaginal delivery in the inpatient setting (assist with second stage (pushing); assist with delivery, assist with third stage (placenta); assist with perineal repair)	1	Real
Complete/Perform a delivery note in the inpatient setting	1	Real
Complete/Perform a postpartum note in the inpatient setting	2	Real
Perform/assist in performing the interpretation of fetal heart rate tracing in the inpatient setting	5	Real
Conduct/Perform and present new OB patient H&P in the inpatient or outpatient setting	1	Real
Conduct/Perform, record, and present new patient H&P observed by a preceptor or supervisor in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real

The Pediatric Clerkship is a six-week clerkship experience, in which students, under the supervision of attending and resident physicians, care for children in both inpatient and outpatient settings. In the inpatient setting, students will work on the teaching service caring for acute illnesses of childhood requiring hospitalization. Students will take histories, perform physical exams and counsel patients (and their families). In the outpatient setting, students will again take histories, perform physical examinations and counsel patients while providing acute, chronic and preventive care. In addition, students will participate in didactic sessions throughout the clerkship.

Assessment Methods	Grade Composition
Written Clinical Evaluations	75%
OSCE	20%
Shelf Exam	5%

Objectives

Develop an appropriate different diagnosis along with an initial clinical assessment and plans for common pediatric problems.
Effectively communicate in a variety of settings such as family centered rounds, patient consultations, family meetings, etc.
Obtain a pediatric history from the parent and when appropriate from the child for common presentations in Pediatrics.
Describe key principles of pediatric medicine.
Apply ethical principles to the care of patients using case studies.
Describe the role of pediatricians in the health care system.

Clerkship Log

Students must meet minimal, quantifiable criteria for successful completion of the Pediatrics Clerkship at The Warren Alpert Medical School of Brown University. The experiences listed below define these criteria.

Please note: simulated patients/alternative experiences are available via didactics and Aquifer cases. Please discuss with the Clerkship Director.

Students must do the following checklist items (includes student responsibility and setting)	Minimum No. of Times	Type of Patient
Evaluate different acute pediatric presentations in inpatient or outpatient setting (e.g. diarrhea, ear pain, fever, strep throat, etc.)	5	Real, Simulated
Perform the calculation of fluid orders in the inpatient or outpatient setting	1	Real, Simulated
Perform/assist in performing immunization determination/administration in the inpatient or outpatient setting	2	Real, Simulated
Perform an inpatient pediatric history & physical exam in the inpatient or outpatient setting	3	Real
Perform a newborn exam in the inpatient or outpatient setting	1	Real, Simulated
Evaluate a growth curve or BMI in the inpatient or outpatient setting	2	Real, Simulated
Discuss social determinants of health with a patient and/or family member including the impact on the child's health/wellbeing. [student responsibility: evaluate]	1	Real
Perform an observed well child check – teenage (including HEADSS assessment) in the inpatient or outpatient setting	1	Real, Simulated
Perform a well child check – infant, observed by a preceptor or supervisor in the outpatient setting (Preceptor or supervisor: fellow, attending, resident)	2	Real
Obtain/Perform a patient history observed by a preceptor or supervisor in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real

The Clinical Neurosciences Clerkship is an eight-week, combined clerkship experience in Psychiatry and Neurology. Students spend four weeks in Psychiatry and four weeks in Neurology. In psychiatry, students are assigned to one site for the full four-week experience, which may be in an inpatient, partial hospital, consult, or children’s hospital setting. In Neurology, students spend two weeks on one service and two weeks on a different service. These service settings may include inpatient neurology, consult neurology, and neurosurgery. Students also participate in an integrated didactic series as part of this clerkship.

Assessment Methods	Grade Composition
Psychiatry
Written Clinical Evaluations	50%
OSCE	20%
Shelf Exam	20%
Observed Clinical Interview	10%
Neurology
Written Clinical Evaluations	50%
OSCE	20%
Shelf Exam	20%
History & Physical	10%

Objectives

Recognize and diagnose the major neurological and psychiatric disorders.
Conduct a comprehensive history and exam for patients with these disorders.
Formulate a differential diagnosis of the major neuropsychiatric syndromes based upon history and examination findings.
Describe the clinical features, differential diagnosis, evaluation, and treatment of common neuropsychiatric syndromes – in both the emergency and maintenance settings.
Recognize and select from the available treatment settings for optimal psychiatric care – inpatient, outpatient, partial hospital, residential.
Compare and contrast the role of family, community supports, and the courts (certification, guardianship) in neuropsychiatric disease and treatment.
Recognize the central role of biopsychosocial and neuropsychiatric formulation in assessment and treatment of patients across settings.

Clerkship Log

Students must meet minimal, quantifiable criteria for successful completion of the CNS Clerkship at The Warren Alpert Medical School of Brown University. The experiences listed below define these criteria.

Please discuss with the Clerkship Director for approved simulated patients/alternative experiences.

Students must do the following checklist items (includes student responsibility and setting)	Minimum No. of Times	Type of Patient
Evaluate a mood disorder in the inpatient or outpatient setting	1	Real, Simulated
Evaluate an anxiety disorder in the inpatient or outpatient setting	1	Real, Simulated
Evaluate a psychotic disorder in the inpatient or outpatient setting	1	Real, Simulated
Evaluate a substance use disorder in the inpatient or outpatient setting	1	Real, Simulated
Evaluate a personality disorder in the inpatient or outpatient setting	1	Real, Simulated
Evaluate a cognitive, developmental, or disruptive behavior disorder (e.g. delirium, dementia, autism, intellectual disability, ADHD) in the inpatient or outpatient setting	1	Real, Simulated
Evaluate suicidal ideation or an attempt in the inpatient or outpatient setting	1	Real, Simulated
Evaluate aggression in the inpatient or outpatient setting	1	Real, Simulated
Conduct/Perform at least one observed psychiatric interview (documented and evaluated) in the inpatient or outpatient setting	1	Real
Evaluate care for a patient receiving prophylactic/preventative medication management in the inpatient or outpatient setting	1	Real
Evaluate care for a patient receiving a “PRN” medication intervention to manage symptoms in the inpatient or outpatient setting	1	Real
Evaluate care for a patient receiving psychotherapy in the inpatient or outpatient setting	1	Real
Contribute to (Evaluate) discussion of level of care for a patient (inpatient vs outpatient vs partial hospital) in the inpatient or outpatient setting	1	Real
Participate in decision regarding voluntary versus involuntary treatment in the inpatient or outpatient setting	1	Real
Evaluate/Manage a patient with a stroke in the inpatient or outpatient setting	1	Real
Evaluate/Manage a patient with a seizure in the inpatient or outpatient setting	1	Real
Evaluate/Manage a patient with an acute neurologic emergency in the inpatient or outpatient setting	1	Real
Evaluate a patient with encephalopathy in the inpatient setting	1	Real
Evaluate/Manage a patient with a peripheral nervous system disorder in the inpatient or outpatient setting (Example: radiculopathy, neuropathy, myasthenia, myopathy)	1	Real
Perform a comprehensive neurological exam observed by a preceptor or supervisor in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real
Obtain/Perform a neurological history observed by preceptor or supervisor in the inpatient or outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real

The Family Medicine Clerkship is a six-week clerkship experience, in which students spend their time in an ambulatory clinic setting caring for patients ranging from the newborn to geriatric population. Students, in working with family medicine physicians, will take histories, perform physical examinations and counsel patients on a myriad of common chronic medical problems such as diabetes, hypertension and depression. Students will also provide care for acute medical issues and counsel patients on preventive care. Finally, students will engage in didactic experiences, ranging from lectures, small groups and team-based learning on issues important to Family Medicine.

Assessment Methods	Grade Composition
Evaluations	50%
NBME Shelf exam	20%
[SACC] Project	15%
Didactic participation	15%

Objectives

Gather accurate and thorough histories from a patients presenting for common presentations in ambulatory family medicine.
Perform a focused, pertinent physical exam for common presentations in ambulatory family medicine.
Formulate appropriate differential diagnoses and initial diagnostic and therapeutic plans for patients presenting with acute and chronic conditions in an ambulatory family medicine office.
Organize and succinctly summarize information from a patient encounter in an ambulatory family medicine setting in an oral presentation.
Organize and succinctly summarize information from a patent encounter in an ambulatory family medicine setting in a progress note.
Apply relevant clinical evidence to develop preventive care interventions and acute and chronic disease diagnostic and treatment plans for patients in an ambulatory family medicine setting.
Demonstrate advanced patient communication skills regarding the interpretation of tests and guidelines, the pathophysiology of disease and chosen interventions.
Reflect on encounters with patients and colleagues to understand role of biases and improve clinical care
Describe the critical role of family physicians within any health care system
Design a community based intervention addressing the social and community context of a particular health issue affecting the community surrounding an outpatient health center.
Describe the indications, contraindications, and complications of common ambulatory procedures and perform the procedures in a simulated environment.

Clerkship Log

The following presentations (and diagnoses) are required to be seen during the Family Medicine Clerkship rotation. The list is long, but should be easily attained over the clerkship rotation at Alpert Medical School.

Please note: simulated patients/alternative experiences are available via Aquifer cases and count towards these minimum requirements. In combination with the Aquifer cases, you should be able to meet these requirements at any site over the clerkship rotation. Please discuss simulated/alternative experiences with the Clerkship Director.

Students must do the following checklist items (includes student responsibility, setting, and additional description)	Minimum No. of Times	Type of Patient / Aquifer Cases
Evaluate/help manage abdominal pain in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 15, 19, 20
Evaluate/help manage abnormal vaginal bleeding in the outpatient setting (menorrhagia, menometrorrhagia, post-menopausal bleeding)	1	Real, Simulated / Aquifer Case(s): AqFM 17
Perform an adult health maintenance exam in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 1, 2
Evaluate/help manage anxiety (GAD, panic disorder, OCD) in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 9
Evaluate/help manage asthma (stable or in exacerbation) in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 13, AqPeds 13
Evaluate/help manage back pain (acute or chronic) in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 10
Evaluate/help manage chest pain (anginal or non-cardiac chest pain) in the outpatient setting	1	Real, Simulated / Aquifer Case(s): AqIM 02
Evaluate/help manage congestive heart failure (stable or in exacerbation) in the outpatient setting	1	Real, Simulated / Aquifer Case(s): AqFM 31
Evaluate/help manage COPD (stable or in exacerbation) in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 28
Evaluate/help manage depression (new presentation or ongoing management)in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 3
Evaluate/help manage diabetes mellitus (type 1, 2, or other) in the outpatient setting	4	Real, Simulated / Aquifer Case(s): AqFM 6
Evaluate/help manage fatigue (acute or chronic) in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 26
Evaluate/help manage gastroesophageal reflux (new presentation or chronic management) in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 19
Evaluate/help manage headache in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 18
Evaluate/help manage hypertension (new diagnosis or chronic management) in the outpatient setting	4	Real, Simulated / Aquifer Case(s): AqFM 8
Evaluate/help manage knee pain in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 11
Evaluate/help manage lipid management in the outpatient setting (calculation of ASCVD risk, consideration of statin therapy or diet therapy)	3	Real, Simulated / Aquifer Case(s): AqFM 2
Evaluate/help manage osteoporosis (diagnosis, screening or management) in the outpatient setting	1	Real, Simulated
Evaluate/help manage pharyngitis in the outpatient setting (consideration of Modified Centor Criteria)	2	Real, Simulated / Aquifer Case(s): AqFM 23
Evaluate/help manage pregnancy/prenatal care in the outpatient setting (diagnosing pregnancy, options counseling, prenatal care)	2	Real, Simulated / Aquifer Case(s): AqFM 12, 14, 30
Evaluate/help manage rash (e.g. contact dermatitis, eczema, drug rash) in the outpatient setting	3	Real, Simulated / Aquifer Case(s): AqFM 16
Treat (Perform) a patient for substance misuse in the outpatient setting (AA, QuitWorks, detox, Suboxone, nicotine replacement)	1	Real, Simulated
Screen (Perform) a patient for substance misuse in the outpatient setting (taking social history involving substance use, AUDIT-C, CAGE, SASQ)	3	Real, Simulated
Evaluate/help manage shoulder pain in the outpatient setting	1	Real, Simulated / Aquifer Case(s): AqFM 25
Evaluate/help manage skin cancer or precancerous lesion in the outpatient setting (skin biopsy of suspicious lesion, Aktinic Keratosis, etc.)	1	Real, Simulated / Aquifer Case(s): AqFM 16
Evaluate/help manage a sleep problem (insomnia, OSA, etc.) in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 3
Evaluate/help manage smoking cessation counseling in the outpatient setting (appropriate counseling for any stage of change; pharmacologic management)	2	Real, Simulated / Aquifer Case(s): AqFM 2
Evaluate/help manage thyroid disorder (hyper- or hypothyroid) in the outpatient setting	1	Real, Simulated / Aquifer Case(s): AqFM 5
Evaluate/help manage upper respiratory infection, not pharyngitis in the outpatient setting (common cold, flu, bronchitis, sinusitis, OM, etc.)	3	Real, Simulated / Aquifer Case(s): AqFM 33
Perform a well-child check in the outpatient setting	2	Real, Simulated / Aquifer Case(s): AqFM 23; AqPeds 2,3,4
Obtain/Perform a patient history observed by a preceptor or supervisor in the outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real
Perform an examination observed by a preceptor or supervisor in the outpatient setting (Preceptor or supervisor: fellow, attending, resident)	1	Real

Electives

Students must complete a minimum of 36 weeks of clinical electives, 24 weeks of which must be taken at Brown. The 36 weeks of electives must include the following:

4 weeks of a sub-internship
6 weeks of a surgical elective. A 4 week surgery sub-internship can fulfill both the sub-internship requirement as well as count as 4 out of the 6 weeks of the surgery-related electives.

Locations

Clerkships put students to work full-time at affiliated institutions and clinical rotation sites during a six- to twelve-week rotation period. Student are assigned on-call duty on scheduled nights and weekends. In addition, as part of the Primary Care-Population Medicine Program, students have the opportunity to work in Longitudinal Integrated Clerkships (LIC).

Clerkship	Duration	Hospital Sites
Medicine	12 weeks	Memorial Hospital, The Miriam Hospital, Rhode Island Hospital, Providence VA Medical Center, Kent Hospital, Newport Hospital
Surgery	6 weeks	Rhode Island Hospital, The Miriam Hospital, Providence VA Medical Center, Kent Hospital, Newport Hospital
Pediatrics	6 weeks	Hasbro Children's Hospital, Women and Infants Hospital, Milford Hospital, St. Luke's Hospital
Obstetrics/Gynecology	6 weeks	Women and Infants Hospital, Kent Hospital
Psychiatry/Clinical Neuroscience	8 weeks	Butler Hospital, Providence VA Medical Center, Rhode Island Hospital, Bradley Hospital, The Miriam Hospital
Family Medicine	6 weeks	Kent Hospital of Rhode Island