CLASS OF 2018 INTRODUCTION TO FOURTH YEAR SCHEDULING & PLANNING Loyola University Chicago Stritch School of Medicine Office of Student Affairs CLASS OF 2018 INTRODUCTION TO FOURTH YEAR SCHEDULING & PLANNING

Agenda Fourth Year & Clerkship Track System Lottery Process Required clerkships Elective requirements, registration & VSAS USMLE Step 2 requirements & timing Residency Planning: Future Meetings Online Resources

Handout Clerkship Track System and its Policies Lottery Timeline Lottery Numbers Fourth Year Calendar Timeline for Elective Registration Calendar 4th Yr Planning Sheet

Calendar Yr 4 start date: First clerkship block starts Wednesday, July 5, 2017 (July = Period “9A”) Qtrly break weeks in September (fall break), in December (winter break), and at end of March (spring break) Match Day and Graduation dates tentatively posted. Graduation should take place Saturday, May 19th. DATES NOT YET FINALIZED!!!

Fourth Year Overview of Requirements 12 weeks of core clerkships Emergency Medicine, Sub-I Wards, Sub-I ICU 30 weeks of elective time available Bioethics Requirements Completion of Ethics Case Paper (should be completed during third year) Completion of Ethics Grand Rounds (min. of 4 sessions total by end of fourth year) USMLE Step 2 CK and CS

Core Clerkships One 4-week Wards Subinternship Offered each period 9A (July) through 12A (April) One 4-week Critical Care Subinternship One 4-week Emergency Medicine Clerkship

Bioethics Requirement Ethics case paper due in Yr 3: March 15, 2017 Four Ethics Grand Rounds must be completed cumulatively over 1st - 4th years

Fourth Yr Track Features Flexibility Opportunity for student choice One required core clerkship and two electives in each of first three quarters Availability of at least half of the elective time in first half of the year The Clerkship Directors will work closely with individual students to help them meet their educational and other obligations (i.e., time for residency interviews, etc) in any given sub-I month. There will not be flexibility with the hard cap of students per month though.

Fourth Yr Track System Assigned to track by lottery Computer generated lottery number Rank order all tracks Deadline to submit rank form is Monday, February 6, 2017

Picking a track… Consider what your elective and residency choice needs may be in each quarter Consider when you might take USMLE Step 2 CK and CS Consider which core clerkships could prep you best for the key electives you will take

Attendance Limited time off for excused absences in both subinternships and emergency medicine (3 days including weekend days) Final exam schedule is NOT changeable Plan holiday or interview travel only after determining the date and time of day of exams Labor Day is a holiday but not a 3 day weekend if service team is not off Thanksgiving is a four day holiday weekend

Clerkship Requirements Purpose and Assignment Process

Subinternships 4-weeks: in-pt medicine (“Sub-I Wards”) Examples of services: Gen Med, OB, Cardiology, Hem/Onc, Surgery, Peds Loyola, Gottlieb, Hines, Resurrection 4-weeks: intensive care unit (“Sub-I ICU”) Examples of services: MICU, SICU, BICU, CCU, NICU, PICU Loyola, Central Dupage, Hines, Resurrection, West Sub Ext Sub-I: Petition sub-I director 60 days prior to start

External Subinternships “Sub-I Selective” Student can submit a petition to the SSOM registrar and Sub-I directors to complete the clinical component of 1 of the 2 required sub-I’s external to SSOM. Must be submitted 60 days prior. There will be no exceptions to this 60 day rule. Sub-I Requirements for external sites will be posted on LUMEN for your review In general, the external Sub-I offering must: -have well-developed educational objectives with clear oversight -be a primary service directly responsible for patient care -be predominantly an inpatient service -place student in a position to take primary responsibility for patient care General rule of thumb: external sub-I experience must mirror those offered at SSOM External sub-I option can work to their benefit by allowing students to meet the sub-I requirement at an institution/program where they might be applying for residency. External sub-I approval is contingent upon CD approval and generally must mirror those offered at SSOM.

Purpose of Subinternships Focus on skills and attitudes necessary to care for hospitalized and critically ill patients Sub-I is about taking care of patients and assuming the responsibilities of the PGY1 resident You should minimize your time away from patient care duties Emphasis is on patient care in the context of wards or ICU; emphasis is not on the specialty Thus, subinternships are posted on SSOM transcript without specialty noted (transcript reads only “Subintern-Wards” and “Subintern-ICU”)

Subinternship assignments Opportunity will be provided to submit preference rank lists for site/service Assignments by lottery to services and sites by late winter through the Sub-I clerkship director (separate lottery process, using track rank list in reverse order) Their tentative plan is to have this done in late February.

Rescheduling Sub-I Changes may be possible according to track system traffic rules May trade entire track or individual clerkship After Subinternship site/service assignments are created, changes must be approved by the director of the clerkship and reported to Registration and Records Absences for interviews must be approved by the clerkship directors in advance

Emergency Medicine 4 week rotation 11 shifts which occur all hours of the day and days of the week Located at Hines or Loyola 4 required educational days Other assignments: clinical question presentation, asynchronous modules, reflection paper

ELECTIVES Policies & registration process Purpose of elective curriculum How to design your program

Electives Course Descriptions online in SSOM Elective Catalog Most electives are 4 weeks in length There are several 2-week electives available 26 weeks of elective time in years 3 and 4 = minimum graduation requirement Of the 22 weeks in of electives your M4 year, your elective program must include 4 full-time electives that are at least 4-weeks in length, i.e., 16 weeks of 4-week electives.

Electives (continued) 12 weeks of elective time permitted away (“extramurals”) 12 weeks permitted in any specialty (in M4 year) Excludes time in core clerkships in the specialty Excludes M3-year elective Includes electives at Loyola and away Includes clinical but excludes research courses Other elective policies in catalog preface

Purpose of Electives Broadens & strengthens clinical experience Tests interest in an area of specialization Provides research or special opportunities Promotes self determination and responsibility for content of program

Building Your Elective Program Content Use “Specialty Elective Guide” at online Loyola Elective Catalog site Talk to faculty and specialty advisor(s) Attend specialty department sessions and ask questions Talk to faculty in your field(s) of interest See Dean Mendez and Dean Sonntag for input Attend Students Advising Students (SAS) programs

4th Year Goals by Season Focus of each quarter Summer Fall Winter Spring

Summer Goals (July/Aug/Sept) Solidify specialty interest May/may not need to take specialty elective at Loyola to earn a recommendation letter (depends on prior exposure) Summer work may bump up performance level Courses provides prep for important externships May need to study weeks/month for USMLE Step 2 prep Preparation of residency application starts Externships start Complete Step 2 study and take CK and CS (more on this later)

Fall Goals (Oct/Nov/Dec) Externships continue Residency interview season kicks in; will you need time off? Should you take DT? Should you plan an away elective that geographically places you in proximity to residency interview locales? Sept/Oct courses could still produce residency recommendation letters Complete Step 2 study and take CK and CS (more on this later)

Winter Goals (Jan/Feb/Mar) Finish interviewing Take courses to round out your education Prepare for starting a residency (what do you still need to learn?) Rank residencies for match (mid Jan - late Feb) International elective?

Spring Goals (Apr/May) Take enrichment courses International elective? Take residency prep electives offered at SSOM Get tuition’s worth by staying enrolled Take DT for personal/transitional use Complete graduation requirements Graduate!!!

Elective Registration Process How & When to Register

Elective Registration Intramurals (Loyola) Review course descriptions & policies in elective catalog online Online elective registration through myLUMEN Sign up starts about 4 months in advance of each elective month’s start date More info from ORR closer to first opening registration date (1st week of March)

Externships (a.k.a. extramural electives, away rotations) Up to 12 weeks permitted usually through another US med school Loyola sign up Timetable does NOT apply Reference AAMC Extramural Elective Compendium and/or VSAS for timeline, websites, contact person at site. Beware that their calendar could be very different from ours. Students are responsible for keeping track of beginning and start dates of rotations. Sign up 1 – 5 months in advance of start date; typically April – mid-May for summer courses. CHECK YOUR EXTRAMURAL SITE’S SIGN UP DATE!

Purpose of externships To get an excellent learning experience To help narrow specialty interests To see a program of interest first hand To work with an outstanding faculty To show your stuff and perhaps get a recommendation letter To assess a program’s compatibility with your needs To do unique non-hospital based experiences

Do you need to do 3 externships (12 weeks)? It depends… On your interests, profile, specialty field and geographical considerations Most students should do one or two Some specialties discourage more than one elective in the field; others promote student enrollment in several. SEEK ADVICE!

Extramural Registration Review policies in SSOM catalog Review visiting student policies on other school’s website Application online: Visiting Student Application Service (VSAS) OR paper: application packet submitted through SSOM Reg & Rec Please don’t do both unless you have verified with school that they require this (yes, a small handful are crazy and want both online and paper applications)

Visiting Student Application Service Developed by AAMC Greater than 3/4th of US medical schools use VSAS to process visiting student applications; the others use their own paper applications. See https://services.aamc.org/20/vsas/public/schools for a list of schools using VSAS. Registration & Records will upload transcripts and certify applications after you have applied to one or more electives. Registration & Records will “Release” applications on VSAS.

Extramural Registration for schools not using VSAS See Rosemary Calcagno in Registration & Records for application packet. Complete Loyola’s extramural application AND other institution’s Visiting Student Application. Often possible to list more than one date or several elective preferences. Compile supporting documents; submit to Rosemary Calcagno in Registration & Records. Dean Sonntag will review and approve application; application packet will then be mailed to extramural school.

Typical Supporting documents Extramural Registration additional documentation (submitted via VSAS or by paper) Typical Supporting documents Proof of liability coverage Current immunization record Proof of UP/OSHA/HIPAA training Proof of hospitalization insurance Possibly SSOM transcript Possibly faculty/dean’s letter of recommendation Possibly criminal background check record Possibly affiliation agreement? Memo of Understanding?

Elective Add/Drop Policy Add: register for electives at least one month prior to start date Drop (Loyola courses): at least one month prior Drop (Extramurals): according to other institution’s policy, typically 4 – 6 weeks prior.

Discretionary Time Use Time for Additional Elective Opportunities OR For USMLE Step 2 study time Residency Interview time off For extramural calendar adjustment (other school’s calendar doesn’t match Stritch’s) For remediation needs For personal needs

Applying for Discretionary Time Off May be taken in one week or longer increments Request must be submitted in advance Submit Discretionary Time requests through myLUMEN Elective Registration page

USMLE STEP 2 CK & CS First attempt CK & CS exams be taken by the end of semester 1 of fourth year (by December 31, 2017) Residencies programs increasingly want proof of successful completion of Step 2 during interview process; majority want proof of passing before ranking candidates (i.e. score needed by mid January 2018) USMLE Step 2 CK & CS must be PASSED to graduate. If a 2nd attempt is needed, scores must be received at least two months prior to graduation (mid-March 2018).

USMLE Step 2 CK planning: Residency considerations If exam is taken before August 15, scores are out before interviews are offered If exam is taken after August 15 and before end of November, scores are out during interview season and before residencies make rank decisions Exams taken in January do not meet school graduation requirements and will not be available to residencies prior to their ranking (not recommended)

USMLE Step 2 CK & CS timing Scores reported approximately 4 weeks after test date. CS: Scores are reported according to a block schedule: http://www.usmle.org/step-2-cs/#reporting

Residency Planning You may want to know now…

Residency Letters of Recommendation Up to 4 letters for ERAS/NRMP programs; often only 3 are requested. Up to three for early match programs Request letters when opportunities present themselves Submitted by writer directly through ERAS LORportal (ability to enter and finalize authors will be available in May)

CVs, etc. Feedback on CV’s Submit updated copy for Dean’s Letter use (exact due date this spring TBA) Personal “unique characteristics” paragraph needed for dean’s letter – (exact due date this spring TBA; instructions will be provided)

Online Resources Loyola Elective Catalog: http://ssom.luc.edu/regrec/elective-catalog/ AAMC Extramural Elective Compendium: https://services.aamc.org/eec/students/index.cfm AMA-FREIDA (Residency program info): http://www.ama-assn.org/go/freida Match info: http://www.nrmp.org/ Residency Web Application process: https://www.aamc.org/services/eras/ USMLE STEP 2 info: http://www.usmle.org/step-2-ck/ and http://www.usmle.org/step-2-cs/ Visiting Student Application Service: https://www.aamc.org/students/medstudents/vsas/ Careers in Medicine: http://www.aamc.org/cim

Future Workshops Dean’s Letter Process Wednesday, March 8th in the evening The Match & ERAS (E-residency application service) Wednesday, April 19th following PCM3 sessions

Ask Questions! It is acceptable, expected, smart Where: Registration & Records (changing your schedule, how to sign up for electives, policies) Student Affairs (what to take, when) Faculty Advisor (what, where, when) Specialty Advisor (where, when, how many) Elective dept. offices (how, which)

Submitting your Track Preferences Go to myLUMEN>Clerkship Tracking Sys.> Fourth Year Track Ranking Form Ranking Form submission deadline is Monday, February 6, 2017 If you encounter any problems, contact Julie Steinecker (jsteinecker@luc.edu)

Questions?