1. 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

2. 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

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

5. 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!!!

6. 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

7. 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

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

9. 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.

10. 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

11. 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

12. 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

13. Clerkship Requirements
Purpose and Assignment Process

14. 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

15. 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.

16. 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”)

17. 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.

18. 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

19. 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

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

21. 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.

22. 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

23. 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

24. 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

25. 4th Year Goals by Season Focus of each quarter Summer Fall Winter
Spring

26. 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)

27. 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)

28. 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?

29. 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!!!

30. Elective Registration Process
How & When to Register

31. 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)

32. 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!

33. 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

34. 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!

35. 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)

36. 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 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.

37. 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.

38. 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?

39. 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.

40. 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

41. 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

42. 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).

43. 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)

44. USMLE Step 2 CK & CS timing
Scores reported approximately 4 weeks after test date.
CS:
Scores are reported according to a block schedule:

45. Residency Planning
You may want to know now…

46. 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)

47. 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)

48. Online Resources
Loyola Elective Catalog:
AAMC Extramural Elective Compendium:
AMA-FREIDA (Residency program info):
Match info:
Residency Web Application process:
USMLE STEP 2 info: and
Visiting Student Application Service:
Careers in Medicine:

49. 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

50. 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)

51. 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

52. Questions?