PREFACE

This Manual of Senior Clinical Clerkship in the Cebu Institute of Medicine has
been prepared to provide the clinical clerks with a reference during their
clerkship training. It contains an outline or the training program, the system of
evaluation employed, the administration of the training program in the different
departments through which the clinical clerks will rotate during the year, and
the rules and regulations governing the training program.

 

When a clinical clerk is assigned to affiliated hospitals, he is subject to the rule­
and regulations at the said hospitals insofar as the same are not in conflict
with the rule­ and regulations set forth in this Manual.

Assignment of clinical rotation for the months of April and October is released
individually to the Senior Clinical Clerk only after he or she has registered for the
semester. For the other months, the assignment is released within five (5) days
prior to the next clinical rotation.

 

A Board of Promotions for the clinical clerks is constituted each school year,
made up of the chairmen of all departments through which the clinical clerks
rotate, with the Director of the Clinical Training Program as Chairman. The
Board will determine the satisfactory compliance with the requirements of
clerkship, and adjudicate matters. As with the Board of Promotions for the other a

academic- year, its decision shall be deemed final and only the Board can reverse
itself: whenever so meritoriously warranted.

 

Satisfactory compliance with the requirements of the Clinical Clerkship Program
is herein defined as follows:

1.      Any clinical clerk who has not incurred absences or any deficiency whatsoever
for the entire duration of the clinical clerkship and has been given a
SATISFACTORY rating in all the departments is deemed to have satisfactorily
complied with the requirements of the clinical clerkship program.

2.      Any clinical clerk who has incurred absences or deficiencies during the clerkship
period but has made up tile same, up to the date of graduation, thereby earning
the rating of SATISFACTORY in the department concerned shall be deemed to have
satisfactorily complied with the requirements of the clinical clerkship program.

Any clinical clerk with an UNSATISFACTORY rating in any department shall
repeat the rotation.

 

The act of registration, an entry of any student into the clinical clerkship program,
is an expressed waiver against claims arising from risks inherent in the program.

Graduation Requirements:

To be eligible as a candidate for April graduation, the following requirements must
be accomplished on or before May 15­

a) School clearance

b) Clearances of affiliated hospitals

c) OB reports

d) Certification of completion of internship

Attendance to Graduation Ceremony:

Only Senior Clinical Clerks who have submitted the complete requirements for
graduation a day prior to the Graduation Day are allowed to participate in the
graduation ceremony.

Completion of Clerkship:

Any deficiencies after May15 must be completed In the succeeding semester to
which the students should enroll. If the students fail to complete the clerkship
within one year, he will have to repeat the entire clerkship program. This Manual
Is not designed for perpetuity in toto. Any portion therefore, may be deleted,
revised or otherwise modified, whenever deemed necessary, by the Board and only
at the time prior to the commencement of any clerkship year, during which this
Manual will be enforced.

 

CLINICAL CLERKSHIP PROGRAM

 

I.                    DUTIES AND RESPONSIBILITIES OF THE CLINICAL CLERK

1.      The clinical clerk will be assigned to an intern-resident team. The clinical
clerk will be given patients, the number of which will be determined
by the resident.

2.      The clinical clerk will accomplish case histories and perform physical
examination on all patients assigned to him. He can be given other
hospital work and responsibilities by the resident depending on the
clerk's abilities and aptitudes.

3.      If the intern is absent or occupied with other hospital work, the clinical
clerk will take over his duties.

4.      The clinical clerk shall accomplish the discharge summaries of all his
patients and shall submit them to the chief resident of the department
within the specified period.

II. EVALUATION

1.      At the start of the rotation to each clinical department, the senior clerks will be given a
pre-test to assess their basic and clinical knowledge of General Medicine. At the end
of clerkship, the students will be given a post-test to assess what they have learned in
clerkship. The results of the two examinations shall constitute part of the total
assessment of the student's performance during his clerkship.

2.      The residents, attending physicians, and the department chairmen will evaluate the
total performance of a senior clerk.

3.      The evaluation of the clinical clerk will involve measurement of the amount of medical
knowledge learned and skills developed during his rotation through the different
departments.

4.      The evaluation of the clinical clerk, duly signed by the chairman, should be submitted
within fifteen (15) days after completion of the rotation to the Director of the Clinical
Training Program.

 

III. EQUIPMENT

The following pieces of equipment are required of each clinical clerk during his
rotation though the different departments:

2. Wooden tongue depressors

3. Linen tape measure

4. 6-inch ruler with centimeter markings

5. Stethoscope

6, Ophthalmoscope & otoscope

7. Sphygmomanometer

8. Neurological hammer

9. Watch

10. Rubber gloves

11. Lubricant jelly

12. Standard medical bag

RULES AND REGULATIONS

Determination or the efficiency and the evaluation of the general behavior of the
clinical clerk is the direct responsibility of the department chairman.

DO's.

1.     1. Patients are the first consideration of the clinical clerk and they should be
treated with the dignity that human beings deserve.

2. The clinical clerk shall be on duty during the prescribed hours in the
hospital subject to call depending on the demands of the service. If he must
be absent, a leave of absence must be filed in the Office of the Clinical Training
Program Director, with a recommendation from the Chairman of the Department.

3.      3. The clinical clerk shall accomplish the appropriate clinical patient records on
any new patient within 24 hours from admission; clinical patient records of
emergency cases shall be completed immediately. Descriptions or operations
assisted, progress notes and other pertinent data should be entered into the
clinical record within 24 hours.

4. The Clinical clerk must accomplish weekly, monthly and final summaries
of the cases assigned to him. When he begins a new service, he shall
begin his summary where his predecessor left off.

5. He should participate in ward rounds of the attending physicians,
consultants, residents, and intern staff at suitable intervals, preferably daily.
If his patient is critical, he should make more frequent visits.

6. When serving on surgical services, he should assist operations of patients
assigned to him unless the privilege is denied for cause.

7. The clinical clerk should at all times observe proper professional decorum and
ethics toward the patients. This includes wearing the prescribed uniform,
addressing the patients properly and conversing with them courteously end
upholding confidentiality in cases handled.

8. He should be willing to receive instruction, Information, constructive criticisms,
advice, suggestions, and assistance from his superiors with the view of improving
his medical education.

9. He should be familiar with common laboratory tests and their Interpretations.

10. Attendance in ward rounds and in all conferences is mandatory.

11.Attendance of the clinical clerk in the autopsy of his patient is compulsory.
He should provide the pathologist with adequate clinical data prior to the said
procedure.

12. The clinical clerk should wear the prescribed uniform with the nameplate
within CVGH and other affiliated hospitals.

13. The clinical clerk is required to provide his own surgical uniform.

14. Any complaint about the nurses or paramedical personnel should be reported
to the Director of the Clinical Training program.

 

DON'TS

1.   The clerk cannot make alterations in the schedules or assignments without written
permission from a responsible superior, at least the Senior Resident on Duty.

2. The c1inic·al clerk is not allowed to accept fees, gifts or presents in any form from
patients or their relatives.

3.    3. The clinical clerk should not give unauthorized statements and information to
patients, relatives, the press, outside agency or any shared public website such
as YouTube.

4.      4. The clinical clerk should not upload videos of school activities to shared public
website such as YouTube without the consent of the school administration.

5.      5. Surgical gown should not be worn outside the operating room.

6.     6.  The clinical clerk has no jurisdiction over the nurses or paramedical personnel.

7.      7. Any clinical clerk under the influence of alcoholic beverages, prohibited drugs,
and other intoxicants is not allowed to report for duty.

8.      8. Gambling, drinking alcoholic beverages, using prohibited drugs or intoxicants
are not allowed within the hospital premises. The clerk should not smoke in
restricted areas.

9.      9. Sleeping and eating are not allowed in restricted areas, specifically nurses' station,
emergency room, outpatient department, patient's room, labor and delivery rooms,
operating room and residents' quarters.

10.  10. The clinical clerk is not allowed to remove any part of the patient's chart at
any time.

V. PENALTIES

1. A report of major offenses and corresponding recommended penalties of repeat
rotation, the Department Chairman shall submit suspension or expulsion to the
Director of the Clinical Training Program within five (5) days from commission of
such offense/s.

The office of the Director of the Clinical Training Program will then notify in writing
(receipt to be acknowledged) the clinical clerk concerned of the offense with the
corresponding penalty/penalties. Contesting action or a request for investigation
must be filed with the Director of the Clinical Training Program within five (5) days
from receipt of written notification. Otherwise, the recommendation becomes final.

2. All extensions shall be served only at the end of the clerkship year within the
department and institution, which recommended the extension. Expenses incidental
to serving extensions or making up of deficiencies shall be chargeable to the clinical
clerk.

3. While serving the extensions, the same set of rules and regulations set forth In
the Manual of Senior Clinical Clerkship of the Cebu Institute of Medicine must be
observed.

OFFENSES INVOLVING ATTENDANCE

4.      Tardiness - a clinical clerk is considered tardy if he reports 15 minutes later than the
official reporting time.

 1st offense                                     - ­ warning ­

2nd offense                                    - library work

3rd offense                                     - one-day extension

4th & subsequent offenses              - one-day extension for each tardiness

 

5. Excused absence - one (1) day extension for every day absent

6. Unexcused absence - two (2) days extension for every day absent. This means
two (2) days extension only for every day absent, NOT 2 days + 1 day = 3 days.
If the clerk was absent during his 24-hour duty, he Should go on 24-hour duty when
he reports back.

7. Unexcused absence during ward rounds and conferences (considered separately)

1^st  offense - warning

2^nd  offense - library work

3^rd  succeeding offenses - one­ day extension for each offense

8. When a clinical clerk abandons his post (reports for work whether on 24-hour duty
or not, but leaves his station of duty without permission from his superior, preferably
the Senior Resident on Duty, and does not come back) he Is considered ABSENT
WITHOUT PERMISSION (AWOP) and shall be given an extension of repeat rotation.
However, if the clinical clerk returns to his post, he is considered to be OUT OF POST
and shall be given seven (7) days extension,

9. Reminder: Senior clerks who have accumulated unexcused absences equivalent to
20% or more or their clerkship will have to repeat the entire clerkship.

                            OFFENSES INVOLVING UNIFORMS AND EQUIPMENT

10. Any clerk without the prescribed uniform, with incomplete uniform or without
nameplate, is considered to have one (1) excused absence.

11. Any clerk with Incomplete equipment as required by each department Is
considered to have one (1) excused absence.

                              OFFENSES AFFECTING LEARNING EXPERIENCES

12.  Failure of the clinical clerk to accomplish the complete history or his patients
24 hours after admission to the hospital is equivalent to fifteen (15) days
extension.

13. A clinical clerk who submitted fictitious clinical data shall be given an extension
of repeat rotation. Subsequent offenses done during the rest of his clerkship will
subject him to suspension/expulsion. Fictitious clinical data is defined as data not
obtained by the clerk himself from the patient or accompanying.

14. Penalties for failure to write progress notes as prescribed by the department where
the clinical clerk is rotating-

1st offense                         - warning

2nd offense                        - library work

3rd & succeeding offenses   - seven (7) days extension per offense

15. Penalties for failure to submit final discharge summary within ten (10) days
after the patient is discharged - for every two (2) days late beyond the deadline,
one (1) day extension per patient.

16. Penalty for late OPD referral - two (2) days extension for every one-day late
beyond the deadline for each case.

17. For CVGH rotations - The clinical clerk shall fill up the PATIENT MEDICAL
SHEET (see appendix) for each patient, either an admission or co-management,
assigned to him. The tracker contains the following patient data: name, age, birthday,
sex, height, weight, hospital number, attending physician, admitting problem/s,
procedures and find diagnosis. The clinical clerk shall also fill up the names of the
intern· in-charge and resident-in-charge for the history, POGS sheet, genogram,
family circle, surgical technique, OPD referral and discharge summary, where
applicable.

In case the care of a patient gets passed to another intern, the tracker sheet shall
also be passed to that intern. The chief residents or representative a day will
correct the patient tracker sheet after discharge or on the day of discharge. Late
submission of patient tracker = 2 days extension for everyone (1) day late.

18. Failure to perform the following assigned tasks during:

18.1 APPLICABLE TO ALL ROTATIONS

A clinical clerk who has been informed by the resident physician to monitor
critically ill patients BUT has failed/refused to clo so shall be given seven (7)
days extension per offense.

 
18.2 SURGICAL & OB-GYNE ROTATION

	Number of days extension
a. Pre-operative, post-operative and anesthesiology care	· 3 days per offense
b. Assist in operation	· 7 days per offense
c. Specimen care	· Specimens and kind of infraction will have to be specified with the corresponding days of extension as agreed by the members of the department concerned.
d. Final surgical technique reports - submitted within 10 days after the patient is discharged.	for every 2 days beyond the deadline, one (1) clay extension per patient.
e. Post-operative care monitoring	7 days
f. wound care	7 days