What Is a Medical Clerkship?

A medical clerkship is a clinical rotation that a third- or fourth-year medical student undertakes to gain exposure to various fields of medicine and to participate directly in patient care. Typically, each rotation is a month during which medical students learn how to interview patients, record chart notes, order and interpret diagnostic tests, and initiate therapies. During the third year of medical school, students cycle through the primary care hospital departments, such as pediatrics, obstetrics and gynecology, general surgery, and medicine. The fourth-year students rotate through many of the same departments, but they also have the opportunity to gain experience in subspecialty departments, such as orthopedics, cardiology, radiology, and ophthalmology. A medical clerkship usually allows each medical student to select a few elective blocks in those areas of medicine in which he is strongly interested.

During the first two years of medical school, students study basic and clinical sciences. The medical clerkship provides the opportunity for each student to apply what he has learned while being supervised by an attending physician. A key feature of the medical clerkship is the daily rounds, during which the students present patient cases to the attending physicians, discuss diagnostic and therapeutic interventions, and answer questions. In this way, students learn how to move from patient history and findings on the examination to making a diagnosis and starting the appropriate treatments. Typically, each medical student follows an assigned list of patients.

In addition to morning work rounds, students participate in various required conferences, grand rounds, and seminars. During grand rounds, entire departments meet to discuss unique cases and diagnostic problems. Students work as part of a clinical team, consisting of the attending physician, resident physicians, hospitalist, and interns, in addition to the students. Medical student responsibilities during a medical clerkship may include writing orders, writing clinical notes, drawing blood, and carrying out other diagnostic procedures. The student must also check laboratory test results and report all findings to the resident physician.

In addition to those already listed, mandatory clerkships for most medical schools include family medicine, neurology, and psychiatry. Some programs also require training in the emergency departments and intensive care units, such as the neonatal intensive care unit and the cardiac care unit. Furthermore, students must obtain certification in advanced cardiac life support (ACLS), during which they learn the necessary steps for resuscitation of a patient who has stopped breathing or whose heart has stopped beating. Medical clerkships also incorporate a rotation in electrocardiogram (EKG) interpretation.