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Year Three

Primary Care Track students spend their third year in a longitudinal integrated clerkship (LIC) on the Heersink School of Medicine’s Tuscaloosa Regional Campus. The Tuscaloosa Campus is part of The University of Alabama’s College of Community Health Sciences. A LIC model moves beyond the traditional block structure of the third-year clinical clerkship. In a LIC, students work closely with physician instructors and build mentoring relationships. Students also develop longitudinal relationships with patients and can observe how their diseases progress or improve, follow pregnant women through to delivery and see their babies develop and grow, and get to know their patients as people in the context of their community and family rather than just as episodes of illness or disease. This differs from the traditional third-year model, where every four to eight weeks students rotate through a different specialty, often in a hospital setting, changing attendings and teaching services, and without the opportunity to follow a patient longitudinally to see how the patient’s illness or disease process evolves. As part of the PCT, students learn clinical medicine, population health and the business of medicine in an environment reflective of where most medicine is practiced. They are active members of health-care teams and work alongside faculty in every clerkship discipline: Family Medicine, Pediatrics, Internal Medicine, Obstetrics and Gynecology, Surgery, Psychiatry and Neurology. They provide acute care as well as continuity of care and preventive services to patients and in multiple settings, including outpatient clinics, inpatient units, nursing homes and the patient’s home. During the past four decades, medical schools in the US, Australia, Canada and other parts of the world have incorporated LIC models into their curriculums. The University of Minnesota, Harvard University, the University of North Carolina, Duke University and Texas A&M University are among the US medical schools using LIC models. Research shows that students in LICs perform as well or better academically as their peers in traditional block clerkships, develop enhanced patient-centered attitudes and skills, are attractive candidates for residency positions, and express more satisfaction with their clinical education than their peers in traditional clerkships.

What does the Primary Care Track look like?

Our LIC consists of two 24-week blocks. All students complete the Tuscaloosa Immersion Experience, which is similar to the traditional block model. Students spend the other block in a LIC either on the Tuscaloosa Campus (Tuscaloosa Integrated Experience) or at an approved community site (Community Integrated Experience). The remaining four weeks of the year consist of two week-long special topics and two weeks of winter holiday.

Tuscaloosa Immersion Experience

Students complete specific blocks on the Tuscaloosa Campus in Internal Medicine (8 weeks), Surgery (4 weeks), Pediatrics (4 weeks), Obstetrics and Gynecology (4 weeks) and Neurology (4 weeks).

Tuscaloosa Integrated Experience

During a 24-week period, students spend either full or half days each week in different specialty clinics working with faculty preceptors. In addition, students attend weekly Relate Sessions during lunch, have instruction in Leadership in Community and Population Medicine (LCPM) regularly, and attend didactic learning sessions throughout the period. Flex time can be used to pursue optional experiences or independent study.

Community Integrated Experience

This is a longitudinal experience at one of our approved community sites where students work alongside our private practice physician preceptors and learn about practicing medicine in small towns and rural communities, and in many disciplines. The Community Integrated Experience has identical learning objectives and expectations as the Tuscaloosa Integrated Experience, and also lets students experience what it means to run a private medical practice and be a leader in a community. Participation in Relate Sessions and didactic learning sessions are available through videoconferencing. LCPM requirements are met through self-directed student activities supported by community preceptors and the Tuscaloosa Regional Campus faculty. Students are selected for the Community Integrated Experience via an application process during the second year of medical school. Successful applicants are academically strong and self-directed learners interested in community-based medicine or practicing in a rural community.

How is the third year graded?

Primary Care Track students are graded using the same metrics as traditional clerkship students and have the same course requirements and objectives. Students receive most of their evaluation from faculty rather than residents.

How do clerkship shelf exams work?

Shelf exams are scheduled throughout the year to be taken at appropriate times for students’ learning.

During the LIC, students also participate in two programs

Relate Sessions

These are weekly discussions focused on personal and professional development and student success. Students have opportunities to connect with mentoring faculty in a non-clinical setting, ensure they are prepared for the steps on the way to residency training, and learn about topics that broaden their medical education in a student-centered, inclusive space.

Leadership in Community and Population Medicine Curriculum

This is a longitudinal course that includes instruction about how to perform a community health assessment, view patient care through the lens of population health and serve as a future physician leader.

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Year Four

Primary Care Track students complete three required four-week rotations.

Inpatient Acting Internship	Can be completed through rotations on the Inpatient Medicine, Pediatric or Obstetrics and Gynecology inpatient services. Completed on the Tuscaloosa Regional Campus.
Acute Care Acting Internship	Can be completed through selected rotations in Adult Critical Care, Emergency Medicine, Trauma or GYN/Surgery. Completed on the Tuscaloosa Regional Campus.
Community Medicine Acting Internship	Can be completed through a number of rotation options which currently include outpatient Internal Medicine, outpatient Pediatrics, Rural Medicine, Community Surgery, Psychiatry, and Sports Medicine. Courses may be added or changed as preceptors and courses are available. Completed on the Tuscaloosa Regional Campus or at an approved community site.

Primary Care Track students complete 18 weeks of electives that may be completed at any of the four Heersink School of Medicine campuses, or as an approved visiting rotation at another institution. A two-week residency preparation course is also required.

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