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Clerkship definitions in purple italics.

Integrated and Rotation definitions in Blue.

Hugh's research on Clerkship definition

Here is the only definition of “clerkship” that I could find from an authoritative source.  It seems that it is a term that is used without a firm definition, other than what we got from Merriam-Webster.

From the ECFMG (emphasis added):

Medical Students participate in clerkships in various clinical departments and medical and surgical specialties. During these clerkships or rotations, they continue to function primarily as students, but their role is more applied to real time patient care. This becomes even more hands-on during the fourth year of medical school during subinternships.


From MeSH:

Undergraduate education programs for second- , third- , and fourth-year students in health sciences in which the students receive clinical training and experience in teaching hospitals or affiliated health centers.


It seems that the criteria for a clerkship are 1) clinical training/patient care (but not as much as a sub-internship), and 2) done with faculty in teaching hospitals (but not a preceptorship which is similar activities but with non-faculty members of the profession).


Current recommended definition for instructional method:

Clerkship/Preceptorship: Undergraduate education programs in which the students receive clinical training and experience and participate in patient care in ambulatory and in-patient settings. Clerkships may occur anywhere in the curriculum, vary in length and may be specialty-based and/or longitudinal and/or integrated. A preceptorship, in which a student works primarily with a single physician or medical group to gain  practical experience in medical and health-related services, may be incorporated into the clerkship, or the entire clerkship may be a preceptorship. [adapted from MeSH for “clinical clerkship’ by Curriculum Inventory Standardized Vocabulary Subcommittee]


Clerkship: a course of clinical medical training in a specialty (as pediatrics, internal medicine, or psychiatry) that usually lasts a minimum of several weeks and takes place during the third or fourth year of medical school (adapted from Merriam Webster)

Integrated: "the organization of teaching matter to interrelate or unify subjects frequently taught in separate academic courses or department." Harden RM, Sowden Susette, Dunn WR. Some educational strategies in curriculum development: The SPICES model. Med Educ 1984; 18:284±97.

Rotation: a clinical assignment for students in a specific clinical area. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003


Note from Hugh:

Here’s the list of terms that I believe need to be clarified in order to clearly understand “clerkship”


With definitions provided by Marian:


Student involvement:

  1. Clerkship*: Undergraduate education programs for second- , third- , and fourth-year students in health sciences in which the students receive clinical training and experience in teaching hospitals or affiliated health centers. [MeSH for “clinical clerkship’]
  2. preceptorship: Practical experience in medical and health-related services that occurs as part of an educational program wherein the professionally-trained student works outside the academic environment under the supervision of an established professional in the particular field. [MeSH for “preceptorship”]
  3. observership: [Clinical Observership]: An educational experience by a medical person who goes to another institution, often in another country, to watch how “they” practice medicine. Observerships usually last a week to a month, but can be longer. The observer usually is not licensed to practice in the host institution, and can only watch, not make medical decisions. From Emergency Medicine News: 02 February 2012 - Volume 34 - Issue 02 - [no page #] doi: 10.1097/01.EEM.0000412292.42561.64
  4. shadowing: Physician shadowing is a process wherein a student or a trainee observes a physician conducting his or her daily work. Also known as a “structured observership”1 or an “observational experience,”2 shadowing is a common activity among students contemplating careers in medicine. [From Acad Med ]


Curricular function:

  1. elective: Courses from which students may select on the basis of personal preference (ERIC)
  2. selective
  3. core (core curriculum): Studies, activities, or courses that meet the common needs of students (ERIC)
  4. required*(required courses)s: Courses required by an institution or administrative body for certification, admission, graduation, etc (ERIC)


Instructional format:

  1. longitudinal*
  2. integrated* (integrated curriculum): Systematic organization of curriculum content and parts into a meaningful pattern (ERIC)
  3. rotation*

Note: items marked with * are terms used in the current Curriculum Inventory specification. (added by Valerie)

More definitions from Marian 

clinical correlation: linking clinical findings together to enhance basic science material in clinical problem solving (from Acad Med.2002 Nov;77(11):1157-8. A computer-based OSCE station to measure competence in evidence-based medicine skills in medical students. Fliegel JE1, Frohna JG, Mangrulkar RS.


  • Clinical vignette (vignette): A vignette is a brief written case history of a fictitious patient based on a realistic clinical situation that is accompanied by 1 or more questions that explore what a physician would do if presented with the actual patient (from American Journal of Medical Quality May/June 2005 vol. 20 no. 3 151-157 doi: 10.1177/1062860605274520)


Comments from Kristi:

I noticed this time through that preceptorship is separate from Clinical Experiences-Ambulatory and Clinical Experiences-Inpatient. When Hugh made a comment on the other call this week, he indicated that preceptorship usually means less responsibility for patient care. That has not been our experience here. In fact, our preceptorship in Family Medicine provides students with much more autonomy than is often the case on other clerkships, because they work primarily with one faculty member for an entire month. So I think we may need to have some further discussion about that term, along with clerkships, electives, and selectives. At our place selectives mean that students must select a specific number of choices from a limited list, whereas electives are a much bigger list and students must just meet a certain number of hours.

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