EA-3114 Required Clinical Experiences in the MD Curriculum

1.0      Purpose

The Liaison Committee on Medical Education (LCME) requires medical schools to define the types of patients and clinical conditions that medical students are required to encounter, the skills to be performed by medical students, the appropriate clinical settings for these experiences, and the expected levels of medical student responsibility. . This policy  establishes the framework for ensuring that all medical students  complete a defined set of clinical experiences essential to the MD curriculum, in support of the school’s commitment to educational quality, comparability across clinical sites, and compliance with LCME requirements. This policy applies to all required clinical clerkships within the VTCSOM MD program. It governs the identification, tracking, and completion of required patient encounters, clinical conditions, and procedural skills.

2.0      Policy

VTCSOM maintains and enforces a standardized list of required clinical experiences that all students must complete during Phases 2 and 3 of the curriculum. These experiences are aligned with VTCSOM educational program objectives and graduation competencies, and with national expectations for undergraduate medical education. Completion of required clinical experiences is monitored centrally and is required for student progression and graduation. VTCSOM uses a centralized clinical tracking system to monitor individual student completion, identify gaps, approved alternative experiences, and verify completion before final clerkship grade submission.

3.0      Procedures

The patient types, clinical conditions, and skills requirements for each clerkship in Phase 2, including level of student responsibility, are developed by clerkship directors with input from faculty, department chairs and education leaders.  National standards and specialty recommendations are also used to inform this process. Students are required to see patients from all broad categories of disorders. Inpatient, ambulatory/outpatient, and emergency department settings are utilized to provide exposure to as many types of disorders as possible.

Each clerkship utilizes a centralized clinical tracking system/digital passport whereby student experiences are documented and verified. The clerkship directors actively monitor the passports and review the progress of each student as part of mid-clerkship feedback and at the end of the clerkship. The Office of Educational Affairs (OEA) centrally monitors completion across clerkships. Students who are not on track to complete required experiences receive guidance and may be assigned to approved alternative experiences, including additional patient encounters, simulations, online modules, assigned readings, and/or written cases. Completion of required clinical experiences or approved alternatives must be verified the clerkship directors in collaboration with the Phase 2 director. All clerkship passports and alternative activities are approved by the Phase Integration Committee 2-3 (PIC 2-3) and the Medical Curriculum Committee (MCC).

If 20% or more of students, in aggregate or at a particular site, cannot meet the clinical experiences for a required clerkship during more than one block in the academic year, the clerkship director will collaborate with the  OEA to assess the reasons for the lack of experiences, consult the professional literature to determine if other experiences and skills could be substituted for existing ones, and decide if changes should be made to the list of required experiences.

Each year, as part of the clerkship end-of-year review cycle, the clerkship directors can propose updates to the patient types, clinical conditions and skills requirements. Any such changes are reviewed and approved by the PIC 2-3 and the MCC. These proposed changes are presented and approved prior to each new cohort entering Phase 2. The patient type and clinical conditions/skills lists are sent to all faculty members on an annual basis and each faculty member attests to reviewing it.

The levels of student responsibility regarding required clinical experiences are as follows:

• Observe (O): the student watches another health care professional perform a task or procedure.
• Interpret (I): the student evaluates pertinence of data gathered during patient care.
• Problem-Focused History and Examination (PFE): The student elicits a focused history and performs a focused physical examination directed by the patient’s chief complaint. 
• Perform (P): the student performs the procedure.

Students must document each experience using the school’s designated clinical tracking system (e.g., One45). Clerkship directors and faculty preceptors are responsible for verifying completion and ensuring accuracy.

Required clinical experiences in the Phase 3 curriculum are reviewed and approved by the PIC 2-3 and the MCC. These required experiences are reviewed annually prior to Phase 3 scheduling (see policy: EA-3214). Proposed changes to clinical and non-clinical (research) requirements are presented and approved by OEA, PIC 2-3, and MCC prior to the class engaging in the Phase 3 scheduling process.

The MCC will conduct an annual review of required clinical experience data, including completion rates, site comparability, and effectiveness of alternative experiences. Feedback from students and faculty will be collected to inform updates to the experience list and improve delivery mechanisms. 

4.0      References

• Liaison Committee on Medical Education. Functions and Structure of a Medical School. Current edition.
• Association of American Medical Colleges. Core Entrustable Professional Activities for Entering Residency.
• VTCSOM Phase 3 Scheduling and Request for Alternatives EA-3214

5.0      Approval and Revisions

Approved by the Medical Curriculum Committee on June 18, 2026