Clerkship Descriptions

The Anesthesiology clerkship is a 5-day rotation that allows students, under direct supervision, to obtain clinical experience in perioperative medicine.  This experience is made possible with a hands-on didactic session as well as direct patient care in the acute setting of the operating room and recovery room.  Students will gain insight into the anesthesiologist’s management of pre-, intra-, and post-operative patient care.  At week’s end, students will participate in a case presentation with one of our faculty members. 

Goals of the Rotation: 

• Learn how to perform a preoperative assessment and appreciate its value 

• Generate simple anesthetic plans tailored to the patient’s co-morbidities and intended surgery 

• Apply basic cardiopulmonary physiology and pathophysiology 

• Understand the pharmacology of commonly used anesthetic agents and vasoactive medications 

• Comprehend how to use the ventilator and manipulate its settings 

• Hone procedural skills including peripheral IV access and basic airway management 

Course Director: Allen Friedman, MD 

Associate Course Director: Kyra Bernstein, MD 

The medicine clerkship is a ten-week rotation at NYP that 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 clerkship 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 group small case-based seminar sessions that meet regularly throughout clerkship.

Learning Objectives 

Fund of general medical knowledge 

Demonstrate a fund of knowledge in pathophysiology, pharmacology and clinical medicine sufficient to evaluate patients with complex medical problems 

Patient-specific knowledge 

Consistently and independently pursue information; know patients well across the entire biopsychosocial spectrum: including relevant pathophysiology, pharmacology, daily progression, psychosocial situation, prognosis   

History taking skills 

Gather accurate information through open-ended as well as specific questions and develop good rapport with the patient 

Physical Exam skills 

Perform a complete exam employing relevant maneuvers and their accurate execution and interpretation 

Data gathering and interpretation 

Acquire and interpret data from old records, the laboratory, imaging and other modalities; understand the rationale for testing, address all abnormal  findings  

Clinical Reasoning 

Consistently generate a prioritized differential, including most likely as well as “do not miss” diagnoses 

Presentations 

Effectively present new patient admissions and follow-ups, formulate cogent differential independently 

Admission and follow-up notes 

Write timely, effective, and easy-to-read admission and follow-up notes that accurately convey the history, formulation, differential diagnosis, and plan 

Communication skills 

Communicate effectively with patients and all members of the interdisciplinary team 

Patient-centered skills 

Effectively advocate for patients by virtue of integrating patient-specific factors and the patient’s perspective 

Longitudinal care: social determinants, health care systems and transitions in care 

Demonstrate an understanding of both patient and health care system factors that contribute to the complexity of longitudinal care and transitions in care.  Appreciate the patient’s perspective: psychosocial factors, new diagnoses the impact of changes in functional status, as well as the physician’s role in medication reconciliation and communication with other providers and health care team members 

Professionalism 

Participate as a trusted team member: consistently assuming responsibility; accepting and incorporating feedback; being industrious, reliable, enthusiastic, helpful and respectful 

Course Director: Rosemary Sampogna, MD, rvs2@cumc.columbia.edu

The neurosurgery clerkship is a one-week introduction to clinical neurosurgery, the subspecialty devoted to the surgical management of patients with diseases of the nervous system.  Students will encounter patients with disorders of the brain, spine, and peripheral nervous system. These disorders will typically include, tumors, vascular malformations, infections, aneurysms, intervertebral disc disease, spinal instability, chronic pain, epilepsy, trauma, hydrocephalus, developmental anomalies, movement disorders, and nerve entrapments.  

Although the majority of the students’ time will be spent in the operating room, some time will be devoted to meeting with the attending preceptor for discussion of various neurosurgical topics, interacting with the neurosurgery housestaff, NPs, and PAs, performing outpatient evaluations and attending educational conferences. Additional time may be spent practicing suture tying, interpreting CT and MR imaging studies, and performing focused neurological examinations. 

Goals and Objectives 

• To develop a basic working knowledge of the diagnosis and treatment of common neurosurgical disorders thru operative observation and clinical discussions. 
• To interpret diagnostic imaging for common neurosurgical conditions.  
• To develop a differential diagnosis for common neurosurgical conditions.  
• To learn basic concepts related to the neurosurgical operating room, such as sterile fields, scrubbing, gowning, use of equipment, interactions with members of the OR team, situational awareness, etc. 
• To learn basic intraoperative skills, such as patient positioning, prepping and draping, making incisions, tissue handling, wound closure, knot tying, etc. 
• To communicate in an effective and professional manner as a member of the neurosurgical team. 
• To understand neurosurgical topics that may appear on USMLE examinations. 

Course Director: Christopher Winfree, MD, cjw12@cumc.columbia.edu

The neurology clerkship is a four-week introduction to clinical neurology, the specialty of medicine devoted to patients with diseases of the nervous system.  It includes three weeks of inpatient neurology and one week of outpatient neurology.  The essential tools for the evaluation of neurological disease are the neurological history, 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 four 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, pediatric neurology, and neurological emergencies.

Students participate directly in the care of patients in the neurology services and ambulatory clinics at Columbia University Medical 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, lumbar puncture simulation, neurological problem-solving, preceptor group sessions, and the Clinical Practice 3 session, focusing on communication, hope, and empathy.

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, an Objective Standardized Clinical Examination (OSCE), and the National Board of Medical Examiners clerkship shelf exam.

Goals and Objectives: 

• Learn to gather a comprehensive neurological history with focused questions and gain confidence in neurological examination skills to further develop clinical localization 

• Clinical synthesis including development of neuroanatomic localization and prioritized differential diagnosis  

• Development and understanding of appropriate diagnostic testing relevant to the conditions under study, including neuroimaging and electrophysiology with formulation of initial treatment strategies 

• Formulation of a diagnostic impression that can be presented in a concise manner both orally and via written notes/write-ups, guided by the literature 

• Learn to effectively communicate with and educate patients and families with compassion, while learning to advocate for them and being aware of social determinants of health which may pose a barrier to care and help them become advocates for their care 

• To collaborate effectively as a member of an interprofessional team and actively listen to all members, having situational awareness and integrating as a member of the team 

Course Director: Comana Cioroiu, MD, cmc192@cumc.columbia.edu

The Obstetrics and Gynecology clerkship is a five-week rotation spent either at New York-Presbyterian Hospital or Stamford Hospital. Students will work with clinicians in both inpatient and outpatient settings and participate in the care of patients with OB/Gyn concerns. Weekly Grand Rounds, student didactics, case review, and small group preceptor sessions enhance the clinical learning experience.   

Clerkship Goals and Objectives:    

• Acquire knowledge of routine OB/Gyn care from reproductive years through menopause; and of normal and abnormal reproductive function.   

• Reinforce skills for taking a reproductive health history and performing a trauma-informed physical and pelvic examination.  

• Participate in the pre-, intra- and post-operative care of patients having Gyn surgical procedures.  

• Hone patient communication skills.     

• Hone clinical reasoning skills and communication with members of the medical team in different settings.  

• Increase awareness of disparities in OB/Gyn, including maternal morbidity and mortality, and access to care; and of efforts to address these.  

• Develop the ability to form differential diagnosis and treatment/management plans for common OB/Gyn conditions, and consider Gyn issues in the evaluation of undifferentiated complaints.  

• Collaborate with colleagues from other disciplines to optimize patient care. 

Course Director: Dara Matseoane-Peterssen, MD, dnm14@cumc.columbia.edu

The Ophthalmology Clerkship is integrated into the Internal Medicine clerkship. It provides a wonderful opportunity to learn more about ophthalmology – what it means, what we do, how and when to call in a consult, and whether you would like to learn more about the field during a month-long elective. You might even decide to apply for an ophthalmology residency! Students spend their time working with faculty, rotating with the consult resident and in the operating room. A robust video lecture series is complemented by a case-based discussion session bringing together systemic concerns from internal medicine, trauma concerns from emergency medicine, and ophthalmic pathology.    

Clerkship Goals and Objectives:   

• Gain exposure to tests of visual acuity, slit lamp examination, ophthalmoscopic examination, and ophthalmic surgery 

• Understand how ophthalmology intersects with multiple critical systemic conditions, including hypertension and diabetes 

• Understand which conditions require ophthalmic consultation 

• Understand how to describe ophthalmic conditions when calling for a consultation 

• Understand different aspects of ophthalmic patient care, ranging from private practice to inpatient needs, as well as surgical care in an ambulatory surgical setting 

Course Director: Lora Dagi Glass, MD, ld2514@cumc.columbia.edu 

Medical students will spend a didactic one-week rotation in orthopedic surgery. The primary teacher is an attending surgeon, with some lectures and demonstrations (suturing, casting/splinting) by the resident staff. Students attend subspecialty conferences, rounds, and patient clinics as well as participate in 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 in both pediatric and adult patients 

• identify the basic diagnostic and therapeutic approaches to common musculoskeletal disorders (both medical and surgical) 

• become comfortable describing/interpreting basic radiographs 

• identify and initiate work-up for orthopedic emergencies (ie compartment syndrome) 

• have an understanding of the myriad subspecialties within orthopedics and their relationship to other medical and surgical services 

Course Director: Katherine A. Rosenwasser, MD, kar2153@cumc.columbia.edu 

Students spend one week on the service engaged in the medical and surgical care of patients across the otolaryngology sub-specialties, including Otology/Neurotology, Head and Neck Surgery, Facial Plastic and Reconstructive Surgery, Pediatric Otolaryngology, Laryngology, and Rhinology & Skull Base Surgery. Emphasis is placed on developing basic knowledge in the specialty and in acquiring the skills of the otolaryngologic examination.  Students actively participate in patient care in the clinic and offices, the speech and hearing department, and the operating room. 

Objectives: 

• Develop familiarity with routine Otolaryngology disorders 

• Practice the Head and Neck physical examination 

• Understand the general approach to the Otolaryngology patient 

Course Director: David A. Gudis, MD, dag62@cumc.columbia.edu

During the six-week Pediatrics Clerkship rotation, students participate in direct patient care in the inpatient and ambulatory (outpatient and emergency department) settings at either NYP-Morgan Stanley Children’s Hospital or Harlem Hospital. Students are given the responsibility to perform histories and physical examinations, present patient cases, and carry out management tasks under the supervision of residents, fellows and attendings in each of these clinical settings.  Over the course of the clerkship, students will develop a greater understanding of normal growth and development in addition to some of the many common pediatric conditions contributing to illness. Patient care experiences are supplemented with conferences, case-based didactics, team-based learning modules, as well as a formative telemedicine OSCE.   

Clerkship Objectives: 

• Obtain a complete history in a sensitive and age-appropriate manner from a child and/or accompanying adult  

• Demonstrate effective verbal and non-verbal communication skills with children and their families/caregivers, taking into account patients’ ages and developmental stages 

• Conduct a pediatric physical examination appropriate to the nature of the visit or presenting concern (complete vs. focused) and developmental stage of the patient  

• Demonstrate ability to deliver succinct, well-organized presentations that are patient-and family-centered  

• Develop clinical diagnostic reasoning skills and basic management strategies for common pediatric conditions 

• Identify impact of both implicit and explicit bias on delivery of care and pediatric health outcomes 

Course Director: Marguerite Costich, MD, mac2464@cumc.columbia.edu

The five-week clinical Primary Care Clerkship provides an exciting opportunity for students to learn and care for patients in a diverse array of frontline clinical settings. Students will acquire knowledge in ambulatory medicine and practice core skills essential to proactively serving a population in holistic and longitudinal fashion. Working closely with seasoned clinicians, students will have ample opportunity to identify ways to help patients and contribute to their care.  A robust weekly didactic curriculum including a formative OSCE augment the clinical learning experience.  

Clerkship goals and Objectives:  

• Acquire ambulatory knowledge base and bedside skills   

• Develop interpersonal communication and patient engagement skills   

• Sharpen clinical communication and reasoning skills (verbal and written)   

• Identify health inequities and structural care barriers, working to overcome the negative consequences of social determinants of health.   

• Understand and navigate clinical uncertainty, aiming to deliver patient-centered and high-value care   

• Collaborate with multidisciplinary colleagues to serve and enhance the health and care receiving experiences of patients

Course Director: Nancy Chang, MD, nmc5@cumc.columbia.edu

Assistant Course Director: Rebecca Leeds, MD, rl2813@cumc.columbia.edu

Students spend their five-week psychiatry clerkship assigned to one of the following clinical sites: NewYork-Presbyterian Hospital/Psychiatric Institute, Harlem Hospital, Gracie Square Hospital, Rockland Psychiatric Center, the Bronx VA, or Creedmoor Psychiatric Center/NewYork-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.  Seminars complement the clinical experience by enhancing the knowledge base necessary to master these skills. 

At the end of the Psychiatry rotation students will be able to: 

• conduct an interview to obtain a psychiatric history and mental status examination 

• organize, record, and present a psychiatric history and mental status examination 

• interpret the findings of a psychiatric interview to generate a differential diagnosis 

• formulate a treatment plan in accordance with the biopsychosocial model 

• make an initial risk assessment with a focus on suicidality 

• describe common childhood psychiatric disorders and their treatment 

• establish and maintain a therapeutic doctor-patient relationship, with an understanding of the factors affecting that relationship. 

Course Director: Janis Cutler, MD, jlc12@cumc.columbia.edu

During your urology clerkship, common clinical problems will be discussed, with an emphasis on recognizing, diagnosing, and treating diseases of the genitourinary system.  You will participate in the care of patients on our primary and consultation services, and you will also be involved in cases taking place in the cystoscopy suite and the main operating room.    

Upon completing this rotation, you should be able to:   

• Learn concepts pertaining to common urologic complaints within some of the core disciplines of the field, inclusive of oncology, voiding dysfunction, reproductive medicine/ andrology, pediatric urology, reconstruction, and stone disease.     

• Understand key considerations in generating a differential diagnosis and plan for a patient presenting with urologic complaints   

• Understand the indications, important procedural steps, and anatomic detail pertaining to surgical cases in urology    

Course Director: Gina Badalato, MD, gmb2107@columbia.edu

The General Surgery Clerkship is a five-week experience where the student is assigned to one of the following four sites: NYP/CUIMC, Stamford Hospital (Stamford, CT), Bassett Healthcare (Cooperstown, NY), or Harlem Hospital. The course is designed to provide clinical experience to improve skills in overall patient care. Students apply knowledge gained in pre-clinical curriculum to clinical scenarios for surgical patients in ambulatory, emergency, in-patient, and intra-operative settings. Students are valued members of the clinical team as they assume responsibility for the overall care of their patients pre- and post-operatively. Throughout the rotation, students gain didactic experiences in team-specific conferences, a broad multi-specialty lecture schedule, Surgery Grand Rounds, and M&M conferences to supplement their “floor” learning. Students receive feedback from residents and faculty throughout the rotation to improve their learning experience. Student demonstrate their knowledge at the end of the clerkship on the NBME Surgery Shelf exam and an in-house Clinical Skills Exam. Doris Leddy is the clerkship coordinator. Students also work with the TCK Surgical Education Fellow, a surgical resident spending one year focused on surgical education.  

Clerkship Goals and Objectives: 

• To build a strong understanding of management of surgical diseases 

• To understand the teamwork and coordination necessary in caring for a surgical patient  

•  To understand resources available in the diagnosis of surgical diseases. 

•  To improve technical and general clinical skills including in bedside and intraoperative procedures (i.e. knot tying, suturing, bladder catheterization, and nasogastric tube placement).  

• To concisely and precisely present patient condition and updates to surgical and non-surgical team members.  

• To gain a broad experience in various subspecialties of general surgery.  

• To identify social determinants of health and their impact on patients’ ability to seek and receive medical care.  

• To collaborate with the multi-disciplinary team that cares for surgical patients. 

Course Director: Roman Nowygrod, MD, rn5@cumc.columbia.edu

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 in order 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.

Course Director: Mike J. Devlin, MD, mjd5@cumc.columbia.edu

Course Director: Patrice Spitalnik, MD, pfs2101@cumc.columbia.edu

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 a Foundations of Clinical Medicine 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 and 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, MD
Course Director
Email: mjd5@cumc.columbia.edu