UPH-DR. JOSE G. TAMAYO MEDICAL UNIVERSITY

Sto. Niño Biñan, Laguna

CLERKSHIP MANUAL

VISION

The aim of the University of Perpetual Help – Dr. Jose G. Tamayo Medical University College of Medicine is to engage in the delivery of the total spectrum of health care and the production of health providers as a contribution to the national development.  This will ultimately help attain the best quality of life for every Filipino.

MISSION

The overall mission of the College is to develop physicians who are experts in human biology, properly endowed with values oriented to the optimum care of the patient.  The Perpetualite Physician is well trained to assume the role of a primary care physician but with facility for undergoing post – graduate training in special disciplines including Public Health, Laboratory Sciences and Research.  The graduate of the College of Medicine, above all, equips himself with proper tenets of medical ethical practice.  He does not discriminate his patients for reasons of social status, creed of religion and race ethnicity.

COURSE DESCRIPTION

Under the medical curriculum, as provided for by Republic Act 5946, the Clinical Clerkship is the final year of the medical course.

The Clinical Clerkship in the University of Perpetual Help, College of Medicine covers a period of twelve (12) months.  Clinical Clerks are trained in the different departments of the Dr. Jose G. Tamayo Medical Center of the University of Perpetual Help System as well as in its affiliate hospitals rendering special services. 

The teaching, supervision and evaluation of the clerks are under the responsibility of the department heads.  He/She may delegate specific responsibilities to the Chief of Section or Executive Training Officers (ETO).  Other faculty members in the department maybe assigned as Clerkship Coordinator or Consultant.  The Resident Physicians in the different departments are part of the team of trainors for these medical clerks.

The Resident Physicians have a recommendatory role in as far as the giving of merits and demerits. The amount of merits and demerits given per offense should be congruent to the one prescribed by the Clerkship Manual.

All demerits recommended by residents should be verified and approved by either of the following individuals prior to their presentation in the Clerkship Promotion’s Board:

                        a. Faculty Clerkship Coordinator

                        b. Executive Training Officer

                        c. Department Chairman

Each clinical service department has specific training programs and a system of evaluation consonant with the competencies that are to be developed.  These are discussed with the students on their first day of rotation.

OBJECTIVES

At the end of the Clerkship Training Program, the student must be able to acquire all the competencies defined by each department; to wit:

1.  Take a complete and accurate history and perform a thorough physical examination on a patient and submit the prescribed report within the required period of time prescribed by each department.

2.  Propose a primary diagnosis as well as differential diagnoses based on history and physical examination.

3.  Identify diagnostic and therapeutic plans to arrive at a more definite diagnosis in the most efficient manner, taking into consideration the relevance and usefulness of the procedure.

4. Discuss the nature, pathophysiology, and clinical manifestations of diseases and their proper management.

5.  Interpret and correlate essential screening and diagnostic examinations such as complete blood count, urinalysis, fecalysis, blood chemistries, ECG, X-ray, etc.

6.  Perform proper basic medical, surgical, pediatric and obstetrical procedures such as gastric lavage, NGT insertion, suturing, IV insertion, spontaneous vaginal delivery, immunization, endotracheal intubation, etc.

7.  Perform emergency procedures such as cardiopulmonary resuscitation and to enumerate and explain the administration of the various life-saving drugs.       

8.  Plan, implement and evaluate community health programs based on priority health problems with a health team and the people in the community.

9.  Discuss methods of preventing the recurrence and of a disease and on how to control its spread. (Primary and Secondary prevention).

10. Practice interpersonal skills communications and relationship with the patient the family of the patient and the medical team.

11. Appreciate the values of sincerity, leadership, integrity, discipline and enthusiasm in dealing with superiors and peers as well as patients.

REQUIREMENTS FOR ENTRY TO THE CLERKSHIP PROGRAM

A student must comply with the following requirements prior to Clerkship:

1. Satisfactory completion of the previous three (3) years of the medical course. He must have taken his third year proper at the UPH-Dr. Jose G. Tamayo Medical University-College of Medicine.

2. Medical and Dental Clearance

3. Completion of Enrollment Procedures:     

3.1 Academic and Administrative Clearance (Dean’s office)

3.2 Payment of tuition and other fees (Finance Office)

3.3 Registrar’s Clearance

3.4 Accomplishment of registration forms for 4th Year Medicine proper.

4. Acquisition of a complete set of instruments and basic paraphernalia in a medical bag. They are the following: Stethoscope, sphygmomanometer thermometer, bandage, scissors, penlight, tape, tourniquet, sterile tongue depressor and neurologic hammer. On a clerk’s rotation in EENT, he/she provides himself/herself with an otoscope and an ophthalmoscope.

5. Prescribed uniform for clerkship: pair of white leather shoes, official name plate and identification card must be available and properly worn. He/she must also provide himself/herself with a green scrub suit and cap, a white lab gown and a pair of slippers for ICU, OR and Nursery use only.

GENERAL GUIDELINES OF THE CLERKSHIP PROGRAM

1.  A medical clerk behaves in such a manner as is expected of a medical professional.  He/she must attend to his/her duties promptly and faithfully.

2.  A medical clerk familiarizes himself/herself with the rules and regulations of his/her place of assignment (hospital, medical center, laboratory, community, etc.).  He/She must make it a habit to read the College’ bulletin board in order to update himself/herself and be informed of new developments or changes in school activities.

            2.1.1. A medical clerk will be given demerits for unsatisfactory performance of his prescribed duties. They however should be used with judiciously and should serve as a tool to motivate the medical clerks to perform their assigned work.

2.1.2. Demerits should only be given to clerks who are remiss in the performance of their work. Mass demerits are NOT to be given to serve as preventive measures to other clerks who did not commit the infraction.

2.2.1.  For emergency cases:

2.2.1.1  Short admitting history with pertinent physical findings and admitting diagnosis - within one (1) hour after admission

2.2.1.2  Typewritten, detailed history and physical examination within six (6) hours after admission.      

2.3.2  For non-emergency cases:

2.3.2.1  Typewritten, detailed history and physical examination---within twenty-four (24) hours after admission.

2.3       A clerk assigned to a patient complete the required records prior to going off-duty from a 24-hour assignment.  He does not endorse an incompletely done medical record.

2.4       The results of laboratory test records of procedures are followed up, interpreted and discussed with the resident physician or consultant.  They are attached to the chart afterwards.

2.5       The medical clerk prepares and completes the discharge summary of patients assigned to him within the prescribed time under the supervision of the resident physician.

2.6          For purpose of case discussions and other legitimate reasons, a clerk may borrow a patient’s medical record                 provided that he has filed an official request form and has surrendered the prescribed borrower’s card.  No hospital medical record is allowed to be brought outside the hospital’s premises.

3. Rotations

A clerk may be assigned to outpatient duty, emergency duty or other hospital activities as the

department requires.

4. Conferences

4.1  A medical clerk attends Resident’s and Consultant’s rounds, except  when attending to a seriously ill patient.

4.2  He participates actively in clinical discussion of cases in the department.

4.3.  He attends all meetings or activities required by the Clinical Program Department, the Hospital and the College of  Medicine.

5. Research Activities

5.1 The medical clerk reads pertinent and updated medical literature (foreign and local) on cases assigned to him.

5.2  He does library research on subjects assigned by faculty staff and submits written reports when required.

6. Community Medicine

6.1 A medical clerk undertakes a public health project with his group and with community residents.

6.2  A medical clerk handles a family case.

6.3  A medical clerk engages in comprehensive health care service.

DEFFICIENCIES, MISDEMEANORS, AND CORRESPONDING PENALTIES

Definition of Terms

1.   Tardiness or late – the arrival of a clerk to an assigned post or place of activity in a period of five (5) to fifteen (15) minutes after the designed appointed time.

2. Absences – the arrival of a clerk to any assigned post or place of activity or review/update/grounds TPC classes by more than fifteen (15) minutes after the designated time, or his total non-appearance for that whole day.

3.   Out of post – the absence of a clerk in his assigned place of activity without permission.

4.   Abandonment of post – the absence of the clerk from his assigned place of activity to the point of leaving the confines of the hospital or College without permission from a resident or consultant after reporting for duty.

5. Justified Tardiness and absence – refers to those lates or absences due to extraordinary circumstances such as sudden illness, inability to leave an emergency or serious patient, assisting in an operation or delivery, and other unavoidable situations.  It is however, required to provide proof of the occurrence before being classified as “justified”.

6. Excused Tardiness and Absences – refers to those lates or absences with prior permission or excuse from authorized persons provided it is justifiable reasons.                                                                                   

CLERKSHIP POLICY ON DROPPED STATUS

A STUDENTS IS AUTOMATICALLY DROPPED FROM CLERKSHIP AS SOON AS ANY OF THE FOLLOWING CONDITIONS OR SITUATIONS EXIST: NO WARNING NOTICE WILL BE ISSUED.

1. Absence of inability to report for a cumulative period of 2.4 months or 72 days.

2. Evaluation of Repeat Service in two (2) departments regardless of duration of rotation.

3. Incurring Leave of Absence of two (2) months (cumulative), even if the LOA is official.

4. Absence Without Leave (AWOL) of two (2) months duration.

5. Recorded as DROPPED in two (2) departments.

•      A student is DROPPED in a particular Clerkship rotation when he/she incurs more than 20% absence or as defined by the department concerned. For example, for one month rotation, 20% comprise of 6 days. The number of days may be shorter if a duty day is counted as two days.

•      Students who are dropped from the CLERKSHIP PROGRAM will be required to repeat the 12  month Clerkship Program the following year.

MAKE-UP POLICIES

·         The make-up period for absences and demerits starts in April for the regular students and November for Octoberians. Merits points are deducted against Demerit points incurred in the same department only, unless merit points are awarded by the Office of the Dean. In the latter case, the Merit points may be awarded in the department where it is most needed be the student.

•      In order to qualify for Graduation, all absences and demerits must be made-up for by the 30^th of April (for Regular students) and November 30 for Octoberians. All clearances must be completed on the same day.