Clinic Department

Internal Medicine

Internal Medicine Courses

Summer Courses

Course duration: 2 weeks

Objectives: This is a required learning experience for medical students after two years of Basic Sciences.

The purpose is to give the medical students the basis of clinical practice, including record management, universal precautions, legal aspects of the practice of medicine and progress note writing among others. The student’s will learn the principles of evidence-based medicine and practice literature searching, critical appraisal of the medical literature and its clinical applications. An intensive course of electrocardiograph is offered, at the end of which the student is to have basic electrocardiograph knowledge that will help him in his clinical experiences and his future growth in this field.

Learning activities are didactic presentations and workshops, hands on experiences and independent study.

Evaluation: Attendance is required for each activity. Pass or Fail of this program is based on attendance

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Report to: Damas Hospital at Ponce – Miguel Magraner, MD, and Staff; La Concepción Hospital at San Germán - Francisco Jaume, MD, and Staff; Hospital San Lucas at Ponce – José Ramírez, MD, and Staff

Course duration: 8 weeks rotation at two different sites

Course Description: To help achieve Medicine Department's objectives, each student will be assigned to a Health Care Teaching Unit which consists of an Attending Physician, a Medical Resident, Intern and 2-3 students to provide Health Care to a number of inpatients (7-10 patients/Health Care Teaching Unit).

The student will be assigned two patients/week for complete work ups. They will be directly supervised by the Resident and Attending Physician. The student's work up will be corrected and final copy signed by the medical resident and attending physician before it is made part of the Hospital Record. Progress notes written by the student must be counter signed by residents before being official. Students are expected to have a minimum of two new patients/week.


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• Master history and physical examination skills with a focus on accuracy and efficiency
• Refine oral presentation skills with a focus on being complete, yet concise
• To formulate meaningful differential diagnoses
• Reinforce evaluation and management of common disorders (diabetes, COPD, angina/ischemic heart disease, CHF, pneumonia, cancer) via (1) patient care experiences and (2) scheduled didactics/case discussions, incorporating principles of evidence-based medicine
• Become familiar with triage and assessment of common cross-coverage issues (chest pain, abdominal pain/GI bleed, delirium, seizures, fever, dyspnea, decreased urine output, acid/base, fever/infections)
• Practice communication skills including coordination of patient care activities with ancillary staff (case managers, social workers, etc…), and discussions with patients and their families regarding diagnoses, evaluation, treatment options
• Serve as a guide and role model and help teach 3rd year medical students and peers on history, physical examination and case assessment.

Clinical Responsibility

1. Will have on call duties every fourth day
2. Will do a maximum of one history and physician examination per day of patients admitted to the Department of Medicine
3. Will be responsible for the follow-up of a maximum of three patients directly supervised by the resident and the attending physicians
4. Will actively participate in teaching and working rounds, as well as other department conferences
5. In addition to bedside teaching in the clerkship, there are a number of clinical conferences that the students and House Staff must attend i.e. Basic Science, Grand rounds, CPC, Mortality Conferences, Attending rounds, all of which will complement the clinical teaching. In addition, the academic atmosphere should stimulate independent study.

Student evaluation
The Clerkship coordinator will develop a composite evaluation based upon feedback from Health Care Teaching Team that includes residents and faculty with whom the student has contact. Evaluation will use a standardized PSM evaluation form. Evaluation will be: 70% clinical performance and 30% case presentation.

Rotation Evaluation
Your responsibility is to evaluate the clerkship site at the end of your clerkship. Your rating of the educational quality of the site and of the precepting you received is important to those who will follow you.


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1. Learn to analyze radiographs so as to develop an ability to distinguish normal from abnormal findings in selected common and emergency conditions.
2. Use radiographic findings to narrow differential diagnoses and outlining subsequent diagnostic work-ups for common medical problems.
3. Understand the patient’s experience of radiological tests and procedures so as to better evaluate the appropriateness of specific studies for given patients
4. Develop an understanding of the terminology used in the description of diagnostic images (e.g. “echogenic mass” on ultrasound, “hypervascular lesion” on angiogram, “increased contrast enhancement” on CT exam, or “decreased signal intensity” on an MRI exam)
5. Develop the ability to order radiological studies and procedures appropriately and judiciously with an understanding of the indications, contraindications and clinical impact of each.
6. Understand the basic principles of radiation protection.

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