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Clerkship Series: 10 Tips to Succeed in a Longitudinal Integrated Clerkship Model

Written by SheMD Editors Prema Vyas and Claire Duican

What is a Longitudinal Integrated Clerkship (LIC) Model?

Longitudinal Integrated Clerkship (LIC) model is centered around continuity. Students are paired with the same clinician over a long period of time in order to help build continuous relationships between the student, clinician, and patients. In the traditional clerkship model, medical students may spend 4 weeks in each clerkship before transitioning to their next site. In the LIC model, students alternate specialties every day over the course of a year to build their knowledge of all clerkships simultaneously. This model allows the medical student to create a continuity panel of patients to follow and gain a better understanding of the specialty. Additionally, the LIC model helps students develop long-lasting relationships with their preceptors and affords more opportunities for feedback.

A LIC schedule might look like the one below:

We’ve thrived with the LIC model and hope to pass on some helpful information we learned along the way. That being said, here are 10 tips and tricks to help you succeed in an LIC program!

1. Feel free to alter your schedule: I used some of my free time to gain extra experience or for patient continuity. For example, if my preceptor had an interesting surgical case, I would go with them on a day I was not scheduled. I would also look up when my preceptors had patients I had been following or procedures that I had not observed and try to go to the clinic those days.

2. Schedule admin time: Something I wish I’d started earlier was scheduling a weekly half-day of admin time into my schedule. You get so excited about seeing and doing all the things, you run out of time to go to the dentist or make that flyer for the SIG you’re in. Block out just a half day per week to take care of non-clerkship activities.

3. Set goals: This tip can also work with a traditional clinical clerkship model. It is important to establish your goals and expectations on the rotation. I would tell my preceptor what the school expected us to achieve on the rotation and what I wanted to get out of the rotation.

4. Patient Panel: A patient panel involves choosing patients from each specialty to follow during your clerkship. I chose patients who I had created genuine connections with. I also asked my preceptors if they had a patient they thought would be comfortable with me following.

5. Jack of all trades: I went into medical school very sure which specialty I wanted to practice, but approached the LIC curriculum as if I were completely undifferentiated. I would walk into my neurology session thinking “time to become a neurologist!” and surgery “time to become a surgeon!” This mindset deepened my engagement and also brought the best out of my preceptors!

6. The above being said…: On your first day of LIC, your preceptors will ask you what field you’re interested in. I found it helpful to say “I am interested in OBGYN but am thrilled to be here because [fill in the clerkship-specific-blank].” When I told my EM preceptor I was interested in OB, they made sure I did every OB US/pelvic exam required that day. While I did plenty of non-OBGYN things too, it was an awesome treat to explore my interest in women’s health in another field.

7. Study for board exams: The LIC model was built for board exams. When you attend 7-8 clerkships simultaneously, you can’t check off pediatrics and forget the immunization schedule ever existed! While this can be overwhelming at times, space-based repetition is an ideal way to study for your board exams and a true strength of the LIC curriculum.

8. Reach for research: Not everyone loves research, but the LIC curriculum might be a great way to meet your future PI! Picture this: you discover your neurology preceptor is studying seizure disorders in children, and you happen to be interested in pediatrics. If they want to bring a student onboard, you have a year or more to work on research alongside them.

9. Keep a journal: You will see many patients and have incredible experiences. If you have a meaningful experience, write it down so you can discuss it during your interviews and in your personal statement.

10. Integrate yourself: This model allows you the time and space to really integrate into the team. During my OB rotation, I also spent a couple of days with the ultrasound technicians so I could work on my ultrasound skills and learn how to read ultrasounds. I worked with nurse practitioners and medical assistants in the practice so I could learn from them.

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