Psychiatry Clerkship

General Information


Grading Policy | Absentee Policy | Call Policy | Work Hours Policy | Electronic Health Record Use


Clerkship grades are primarily determined by your clinical evaluations and final exam score. However, your entire performance, including the evaluator’s comments, acceptable completion of all clerkship requirements, participation during didactics and completion of e-learning activities, are reviewed and can contribute. Issues with attendance and inadequate completion of clerkship requirements can impact your final grade.

Clinical Grade (will account for 60% of your final grade)

Your Clinical Grade will be reported on your clerkship evaluation as a Fail, Pass, High Pass or Honors based on the UWSoM ESPCC (Evaluation of Student Performance in Clinical Curriculum) from each of your supervisors. Faculty, resident and other staff evaluations all contribute equally, however, these scores are weighted by the amount of time an evaluator spent with you, ensuring that evaluations from people who worked with you more will count more towards your grade. A combination of the 12 evaluative areas and the “recommended overall level of evaluation” on the ESPCC will be used to determine the ESPCC average and translated into the Clinical Grade as described below:

Average ESPCC score Clinical Grade
> 4.8 "Honors"
Less than 4.8 and = 4.0 "High Pass"
Less than 4.0 and = 3.0 "Pass"
Less than 3.0 Will be reviewed for possible final grade of "Fail"

A failing Clinical Grade (average ESPCC score of < 3.0) may result in failing the clerkship regardless of your Exam Score. Not completing clerkship requirements will negatively impact your Clinical Grade.

Exam Score (will account for 40% of your Final Grade)

We use the NBME clinical science exam in psychiatry as our final exam. The Exam Score reported on your clerkship evaluation will be the NBME national percentile you achieved on the exam. There is no minimum NBME exam score necessary to receive a final grade of Honors or High Pass though low scores will clearly negatively impact your Final Grade. You must receive above the 1st percentile on NBME exam to pass the clerkship and, if you score below the 1%tile you will be required to repeat the entire clerkship.

Calculating your Final Grade

Your Clinical Grade (accounting for 60%) and Exam Score (accounting for 40%) will be combined to determine your combined grade. Your combined grade will be compared to clerkship the historical average (HA) and translated into the Final Grade as described below:

Combined Grade Final Grade
= 0.5 s.d. above the HA1 "Honors"
Within 0.5 s.d. and -0.5 s.d. of the HA "High Pass"
> 0.5 s.d. and = 2.0,s.d. below the HA "Pass"
> 2.0 s.d. below the HA
Will be reviewed for possible final grade of "Fail"
1Refers to clerkship historical average (HA) and standard deviation (s.d.)

If your combined grade is > 2 s.d. below the clerkship historical average your performance will be closely reviewed and you may receive a failing grade for the clerkship.

Top of Page

Clerkship Absentee, Weather and Holiday Policy

The Patient Care Phase Committee, which is composed of clerkship directors, students, and members of the Dean's Office, developed the following policy related to absences from clinical coursework. These guidelines are also on the Web, will be provided to you as part of the Clerkship Track Scheduling material in the fall of the second year, and are included as part of each clerkship's syllabus.

General Absentee Policy

  1. It is in the student's best interest to be present for all days during clerkships. Please try to anticipate personal events and fit them into breaks or elective time off.
  2. Time is too short during two-week clerkships to allow any anticipated time off.
  3. Absences should not be planned during orientation, final examination, or other required elements of the clerkship.
  4. Students needing any time off should consult with the appropriate Clerkship Director at least six weeks prior to the beginning of the clerkship to make sure there are no conflicts with #3 above and to limit the negative impact on the clerkship experience.
  5. Students absent without permission may receive a Fail grade and may be required to repeat the clerkship. In addition, students may also receive an Unacceptable professionalism grade.

Anticipated Absences

1. Personal Events

Personal events include weddings, graduations, presenting papers at conferences and receiving awards. If more than two days off are needed during a four to twelve-week clerkship, the clerkship should be rescheduled.

2. Vacations

There are no vacation days during clerkships except for Match Day and possibly holidays, as discussed below. Please schedule vacation days during school breaks or time off.

3. National or Religious Holidays

As a member of a health care team during clerkships, there is no guaranteed time off for University of Washington holidays, traditional observances, or major days of religious significance, just as there won't be when you are a practicing physician. Students are expected to follow the holiday practice of the clinic/hospital/site at which they are rotating. Meaning, if it is a holiday at your site, you may get the day off. If it is a working day for your site, you must show up. Clinical responsibilities such as night call and rounding take precedence over holiday schedules. To plan ahead for national holidays, you may wish to call the practice site in advance and inquire.

The UW SOM clerkship committee encourages faculty and students to work together to accommodate students' scheduling constraints in observing their central religious and cultural practices. Similar to when you are in practice, you must take responsibility and plan ahead. If you have religious holidays that require you to miss or modify work, consult with the clerkship director well in advance to see what accommodations can and can't be made.

4. Residency Interviews

Students should schedule time off for residency interviews. If interviews are offered when students are already scheduled for clerkships in the fourth year, students should work directly with the Clerkship Director right away regarding absences for residency interviews.

5. Match Day

All graduating students will be allowed to attend the Match Day celebration with no clerkship responsibility starting at 8AM on Match Day until the next morning (variable start time depending on the clerkship). For students doing WWAMI clerkships, additional travel time the day prior to the celebration may also be needed.

6. Travel

If your next Clerkship site requires travel you can take the last day of the clerkship as a travel day. Please discuss this with the clerkship director or the main preceptor at your site.

Unanticipated Absences

1. Unanticipated Illness or Personal Emergency

Students missing ANY number of days must speak with the site director as well as the attending or resident in charge prior to the start of the shift. It is not acceptable to leave only a phone or email message or to contact only administrative staff. Students should receive confirmation (direct conversation, return email or phone call) from the site director and/or the attending/resident in charge indicating that the team is aware of the student's absence. The specific person and his/her contact information are available on the individual clerkship websites.

Students missing THREE OR MORE days must also contact the Clerkship Director who will determine if make-up time is needed for unanticipated absences or if the entire clerkship needs to be rescheduled. Grades may be delayed until the time is made up.

If a clerkship exam must be postponed, the student should contact the Clerkship Director to determine if the exam should be rescheduled as soon as possible or delayed until the next time the exam is given. Progress in other clerkships may be interrupted until the examination is taken depending on the situation surrounding the delay.

2. Inclement Weather

The inclement weather policy for clerkships matches the policy for holidays. If your team is working in the hospital or the clinic is open, you are expected to show up. If you are unable to access the hospital/clinic due to hazardous travel, you must notify your team as described above.

Revised and Approved by Required Clerkship Committee: April 2013

Top of Page

Call Policy

If you have any call requests they must be received at least 3 weeks before the start of your rotation. The final call schedule will be posted 2 weeks before the start of the rotation. If you need to make changes after the deadline you will have to wait until the rotation starts and find a classmate to trade call with.

Seattle sites

Call is from 5:00 to 11:00pm. There is no overnight call. On the weekends call is from 8:00AM to 4:00PM or from 4:00PM to 11:00PM. The frequency of call is approximately once per week. We do not assign call to students the first night of the rotation or the night before the exam.

Sites other than Seattle

The call requirements vary from site to site. Regardless of your site there is no call your first night of the rotation or the night before your exam. If there is call at your site it would be no more frequent than approximately once per week.

Top of Page

Work Hours Policy

Clerkships WITH call

  1. No more than 80 hours of awake time in the hospital per week.
  2. Post-call, if you did not sleep, go home at the same time as the intern or resident, within 30 hours of starting the prior day.
  3. Post-call, if you slept at least 5 hours, you should stay through the working day.
  4. You should have at least one full day off per week, averaged over a month.
  5. No matter how many hours you have worked, always check out with the team before leaving for the day.

Clerkships WITHOUT call

  1. No more than 80 hours of awake time in the hospital per week.
  2. Parking and transportation issues may demand you leave the hospital by a certain time.
  3. Feel free to come in early or stay late. Family and personal obligations are important and need to be balanced.
  4. You should have at least one full day off per week, averaged over a month.
  5. No matter how many hours you have worked, always check out with the team before leaving for the day.

Hours will not be specifically logged unless you feel it is necessary because of a potential violation. If you are working close to the 80-hour limit, please document your hours for the week in question and present these to your Site Director as soon as possible; your work schedule will be modified as appropriate. Also document any violation of the 30-hour policy for overnight call. Further concerns should be brought to the attention of the Clerkship Director. You will never be discriminated against for following the work hours policy

*Software capable of displaying a PDF is required for viewing or printing. You may download a free copy of Adobe Reader from the Adobe website.

Electronic Health Record Use

Medical Student Electronic Health Records (EHR) during clerkships

Effective Academic Year 2015

AAMC recent advisory on Electronic Health Records (EHRs) in Academic Health Centers states:

The AAMC has developed Core Entrustable Professional Activities (EPAs) for Entering Residency—guidelines intended to help bridge the gap between patient care activities that new physicians should be able to perform on day one of residency training and those they feel ready to perform without direct supervision—that are now being pilot tested by 10 medical schools. It is apparent throughout the guidelines that the ability to work in an electronic health record is an important tool to achieving the desired skills for each of the EPAs. Two of the EPAs speak directly to the student’s ability to interact with the EHR: “Enter and discuss orders and prescriptions” and “document a clinical encounter in the medical record”.

The University of Washington School of Medicine recognizes the importance of educating medical students who will be fully prepared for all aspects of residency training and medical practice in the modern era. This includes appropriate exposure to and experience with the EHR. To achieve these goals the University of Washington School of Medicine policy on medical students and the EHR is as follows:

  1. Medical students will have their own unique login and password to access and search the EHR. (Medical students will not be asked to use the login/password of their preceptor or other provider; as such actions would be inconsistent with the appropriate practices of EHR security and compliance which all providers must observe and which we must teach to our students.)
  2. Medical students are expected to comply fully with all aspects of EHR security, consistent with the points noted above.
  3. To assure an appropriate educational experience medical students are expected to perform the following activities:
    1. Review/update the past, family/social history/problem list and review of systems
    2. Enter and complete chart notes (including assessment and plan)
  4. Additional medical student activities in the EHR should be sought to enhance the educational experience. These activities include entering (pending) orders (with appropriate co-signatures).
EHR-related logistics may be complicated; unique issues may exist at individual sites.
If a training site recognizes potential challenges with any element of this policy, site directors should contact clerkship directors to address issues and assure the appropriate educational experiences

Top of Page