Development of a longitudinal integrated clerkship at an academic medical center

Med Educ Online. 2011 Apr 4;16. doi: 10.3402/meo.v16i0.5939.


In 2005, medical educators at the University of California, San Francisco (UCSF), began developing the Parnassus Integrated Student Clinical Experiences (PISCES) program, a year-long longitudinal integrated clerkship at its academic medical center. The principles guiding this new clerkship were continuity with faculty preceptors, patients, and peers; a developmentally progressive curriculum with an emphasis on interdisciplinary teaching; and exposure to undiagnosed illness in acute and chronic care settings. Innovative elements included quarterly student evaluation sessions with all preceptors together, peer-to-peer evaluation, and oversight advising with an assigned faculty member. PISCES launched with eight medical students for the 2007/2008 academic year and expanded to 15 students for 2008/2009. Compared to UCSF's traditional core clerkships, evaluations from PISCES indicated significantly higher student satisfaction with faculty teaching, formal didactics, direct observation of clinical skills, and feedback. Student performance on discipline-specific examinations and United States Medical Licensing Examination step 2 CK was equivalent to and on standardized patient examinations was slightly superior to that of traditional peers. Participants' career interests ranged from primary care to surgical subspecialties. These results demonstrate that a longitudinal integrated clerkship can be implemented successfully at a tertiary care academic medical center.

Keywords: academic medical center; clinical education; continuity; curriculum; education; longitudinal integrated clerkship; medical; undergraduate.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Academic Medical Centers*
  • Adult
  • Analysis of Variance
  • Clinical Clerkship*
  • Curriculum
  • Education, Medical, Undergraduate / methods*
  • Educational Measurement / methods
  • Educational Status
  • Emergency Medicine / education*
  • Faculty, Medical
  • Female
  • Focus Groups
  • Humans
  • Inpatients
  • Learning
  • Longitudinal Studies
  • Male
  • Patient-Centered Care
  • Program Development
  • Program Evaluation
  • Qualitative Research
  • San Francisco