WRITE Program Requirements
All WRITE sites offer 3 weeks of outpatient Pediatrics, 3 weeks of outpatient Psychiatry, the entire 4 week Chronic Care Clerkship and the entire 6-week FM Clerkship. Sites approved as IM teaching sites (22-week sites) will offer 6 weeks of primarily outpatient IM. Sites without IM (18-week sites) will offer a 2-week FM Clinical Elective (in addition to the 6-week FM clerkship).
Department Requirements Tracker: https://courses.washington.edu/fmclerk/write/
- Chronic Care
Chronic Care Mid-end Clerkship Review Form (PDF)
The four week chronic care curriculum consists of elements of rehabilitation medicine, palliative care, geriatric medicine, and chronic pain.
The goals and objectives of the chronic care disciplines should be incorporated throughout the entire WRITE experience. The WRITE lead preceptor will function as the WRITE Chronic Care site director. The chronic care component involves students delivering medical care to patients and families dealing with chronic illnesses, chronic pain, or needing palliative care as the end of life approaches.
While students will learn aspects of the clinical disciplines of rehabilitation medicine, geriatric medicine, pain management, and palliative medicine, the curriculum will also focus on integrative learning experiences to help the student understand the process of medical care from the perspective of the patient and family.
Students will be introduced to the obstacles that patients face and the resources that patients access in living with disability in their homes and communities, or dealing with dying, outside of the hospital ward or clinic visit.
Chronic Care curriculum requirements, are available at the Chronic Care Catalyst page and include required readings, logging patient visits, participation in a video curriculum, completing an ADL assessment: completing a home visit write-up and presentation, evaluation of a patient, a write-up of a therapist observation/interview, POGO-e sessions, as well as monthly particiation in UW TelePain session (students to email Sam Galey, firstname.lastname@example.org when they attend a TelePain, letting him know that they are a WRITE student). Telepain is a weekly audio- and videoconference consultative session bringing together interprofessional specialists with experience in managing chronic pain and community practice providers. These videoconferences include didactic presentations by the pain faculty and case presentations from providers with questions. Please read more about Telepain at http://depts.washington.edu/anesth/care/pain/telepain.
It is expected that students complete chronic care curriculum requirements throughout WRITE with a minimum goal of completing at least two assignments every four weeks.
Chronic Care Goals and Objectives
The student will be able to sensitively and effectively communicate a poor prognosis to patients and families, and provide appropriate counseling around this information using best demonstrated clinical practices.
The student will be constructively involved in a team approach to care of patients with chronic illnesses.
The student will be able to identify and perform appropriate clinical and functional assessments of patients with chronic disease, disability, and life limiting illness.
The student will be able to identify how systems of care affect the delivery of care for patients with chronic disease, disability, and life limiting illness.
The student will be able to use approaches to patients and families that support appropriate management of medical conditions outside of the hospital and clinic setting.
The student will be able to elicit and understand the patient and family's perspective on the management of medical issues, including individual preferences, cultural perspectives, and religious beliefs as they affect the perception of care.
- Family Medicine Clerkship
Family Medicine Clerkship
Family Medicine Clerkship important dates for WRITE Students:
- Required Family Medicine Orientation Webinar: Traditional WRITE session: Monday, January 4, 2016, noon to 1 pm PST.
- Clinical Reasoning Webinar Sessions Scheduled Noon to 1 pm Pacfic Time, offered several times during WRITE session: Students are required to attend once: 1/19/16; 2/29/16; 4/11/16; and 5/23/16.
- Online Final Exam: MT WRITE Thursday, February 11, 2016 from 9:30 am to 12:30 pm Pacific Time; Traditional WRITE session: Thursday, May 5, 2016, 9:30 am to 12:30 pm Pacific Time
WRITE Preceptor Responsibilities for FM CLERKSHIP
The UWSOM Family Medicine Clerkship is a mastery clerkship: Students are assessed on their mastery of the core skills and knowledge of Family Medicine at the end of the rotation. All WRITE students earn six weeks of Family Medicine credit and will be required to complete Family Medicine's Curriculum, including the exam. The UWSOM Department of Family Medicine Clerkship Web Site http://depts.washington.edu/fammed/education/courses/clerkship/ is where you will find goals, requirements, expectations and teaching tips.
- Toward the end of the WRITE session, the primary preceptor is expected to complete a formal evaluation of the student using the online evaluation system, E-Value. Available on the Family Medicine, Info for Faculty Website are evaluation aids including the Feedback & Evaluation Form (Grade Anchors) which can be downloaded, printed and distributed to preceptors who worked with the student in family medicine.
- Primary preceptors can use collected responses to input student evaluation into E-Value. More information on using E-Value and a direct link into the system will be sent to the primary preceptor at the time evaluations are due.
- Grades are assigned in the Seattle office based on the scores and comments on the final evaluation from the WRITE sites.
Note for WRITE Regarding the WRITE Curriculum Tracker and Required Feedback Sessions with Preceptor:
Students should keep their curriculum tracker updated and share it with his/her primary preceptor during the monthly written and verbal feedback sessions (PDF). During the review meetings, the preceptor will give feedback about student's performance in the clerkship. Feedback may include things done well and areas that should be focused on for improvement. Students are encouraged to ask questions during these meetings about the feedback and request further guidance about improving performance.
*The Family Medicine Clerkship web site is set up for the traditional 6-week clerkship. Taking into account the expanded nature of the WRITE program, it is not required that WRITE students complete at the same pace the weekly activities of the FM "Assignment Tracker," but should integrate the "weekly" requirements into their clerkship experience as it makes sense to do so, making sure to complete everything by the time of the Family Medicine exam.
Family Medicine Contact Information:
UW Department of Family Medicine, Clerkship Coordinator
Tel: 206-543-9425 Fax: 206-543-3821
- Family Medicine Elective (only at 18-week sites)
Family Medicine Elective
WRITE students at 18-week sites earn a two-week Family Medicine Elective credit. During students' last three weeks (we suggest three weeks for this two week elective since students are also finishing up their other clerkship requirements and WRITE projects) of WRITE, they must work primarily with their Family Medicine preceptor(s). Students are expected to perform, and will be evaluated, at a higher level for this experience than for the required clerkship experience as they have now completed all 3rd year required clerkships and essentially are fourth-year students.
Goals, requirements, and expectations for the FM Elective are located on the "Sub-Internship Resources for Preceptors" section of the FM web site.
At the end of the two-week elective, the primary preceptor is expected to complete a formal evaluation of the student using the online evaluation system, E*Value. Please refer to the FM Web site for information about grading criteria and anchors. The primary preceptor can use collected responses from other preceptors to create a final evaluation in E*Value. More information on using E*Value and a direct link into the system will be sent to the primary preceptor at the time evaluations are due.
Family Medicine Contact Information:
UW Department of Family Medicine, Clerkship Coordinator
Tel: 206-543-9425 Fax: 206-543-3821
- Internal Medicine (only at 22-week sites)
The internal medicine clerkship is a twelve week clinical experience: eight weeks are focused on care of hospitalized adults and four on primary care internal medicine. Students who are doing internal medicine as part of WRITE all spend six weeks learning inpatient medicine at a large hospital in Seattle or Spokane; most will have been at one of the three major teaching hospitals: University of Washington Medical Center (UWMC), Harborview Medical Center (the county hospital for the Seattle area), the Seattle VA Medical Center, or at Sacred Heart in Spokane. While at their WRITE sites, students will work with ambulatory internists for another six weeks to complete the primary care portion of their internal medicine training.
What students do in Seattle or Spokane
What they see
What students do in Seattle or Spokane
For students at the five academic hospitals, they will have been part of a resident team, usually made up of a faculty attending, a senior resident, one or two interns, and one or two medical students. On average, students admit 1-2 patients every 3-4 days and carry 3-5 patients at a time, although specifics vary widely based on the logistics of the hospital and the abilities of the students. Each hospital serves a different population: UWMC has more patients with organ transplants and other esoteric problems, while patients at Harborview are more likely to have illnesses associated with poverty or homelessness, and the patients at the VA are a mix of older and younger veterans with differing medical problems. While at Virginia Mason, students will see a broad range of patients, including many who have illnesses typical for a urban, academic medical center (pneumonia and CHF) as well as a significant number of patients who come from all around the region for tertiary specialty care (ERCPs, severe acute pancreatitis, pancreatic cancer). Sacred Heart in Spokane is a regional tertiary care center drawing from not only the Eastern Washington area, but also Idaho and Montana. They typically have at least one to two diagnostic dilemmas on each service a week. As the major community hospital for Spokane, the student receives an excellent perspective of the community internist’s scope of practice--ranging from COPD exacerbations to GI bleeds. Sacred Heart also functions as the county hospital for the Eastern Washington area, so there is also a fair amount of indigent patients and the accompanying medical diseases associated with drug use and other poverty related illnesses.
What they don’t see
Because of changes in residency work hours, most residents no longer take overnight call; many students will not have been in the hospital overnight despite having spent six weeks on an inpatient medicine rotation. They also will have seen very few patients with chest pain or heart disease, because cardiology is a separate service at the academic hospitals. A few students may have had exposure to the ICU but most won’t. Ambulatory experience will also be very limited.
Clerkship curriculum requirements
In addition to six weeks of inpatient care, students should have completed the cardio-pulmonary mini-CEX, 6 of the 12 required lectures (the remainder are online) and 9 of the 12 required PxDX logged patient encounters. Students are strongly encouraged to complete the 12 required online SIMPLE cases before leaving Seattle; they must complete them before taking the exam.
What students should do during WRITE
Primary care internal medicine
The core of the IM training experience during WRITE is working with a primary care internist. A WRITE student who spends one day per week working with a primary internist during their entire WRITE block will have a good opportunity to meet the educational goals for the primary care portion of the clerkship. Alternatively, 4 - 5 weeks full-time in an internist’s office would also satisfy this clerkship requirement.
We also hope students will have an opportunity to work with adult and geriatric patients in other settings, particularly by taking advantage of the opportunity WRITE offers to follow patients they meet in clinic. Seeing those patients in the hospital, making nursing home and home visits, and visiting subspecialists with patients can all be very high-yield. Students may also benefit from working directly with subspecialists, hospitalists, or in emergency department settings but this does not meet the core requirement for primary care internal medicine.
Clerkship requirements completed during WRITE
Students should complete both the required SIMPLE Cases and the online lectures before taking the final exam in March. They should also complete any remaining patient logging in E*Value before finishing the WRITE experience.
WRITE students must take their final exam during WRITE. Because the exam is created and monitored by the National Board of Medical Examiners, students must take it at a site where appropriate proctoring is available. Students who have not already been in contact with Carmelita to determine their site selection for the exam should contact her at email@example.com no later than 6 weeks into WRITE session to ensure sufficient time to make arrangements.
Web site and preceptor’s guide
The Department of Internal Medicine Clerkship web site is at https://catalyst.uw.edu/workspace/medsp/30311/201303. On the site you will find the core clinical concepts, expectations, grading using P/RIME, and educational resources. All IM physicians at WRITE sites should read the WRITE IM Guide (PDF).
Print textbook and online resources
Each WRITE student is responsible for bringing a copy of the course syllabus/orientation materials and Internal Medicine Clerkship Guide, by Paauw DS, Burkholder L, Migeon M, eds. 2007. They also have access to the full online content of the UW library system through the HealthLinks care provider toolkit, http://hsl.uw.edu/toolkits/care-provider. We strongly recommend that preceptors encourage students to use their library access to look up relevant clinical topics when they see patients; we find that this real-time use of the literature both helps the student retain knowledge and encourages them to develop efficient search strategies that will serve them well later in practice.
Site preceptors: Our grading system (both in Seattle and at WRITE sites) relies on direct evaluations by the internists working with the students. Internal Medicine requests that the names and email addresses of the Internal Medicine preceptors who work with the students at each WRITE site be emailed to your regional office who will then forward to the student program manager in Seattle. During the first month of WRITE, please send the schedule for when the student works with internal medicine preceptors. The preceptors will receive prompts to do evaluations on their students (see printable pdf--available here as a tool. All evaluations must be entered online into E-Value) as prompted by the department throug E-Value--dependent on each site/student’s IM schedule. These progressive evaluations are then combined with the grades from Seattle to determine the final grade for the course.
Chris Knight, MD
Associate Clerkship Director for WWAMI & WRITE
Jenny Wright, MD
Associate Clerkship Director for Greater Puget Sound & WRITE
The UWSOM Department of Pediatrics Clerkship web site is at http://www.washington.edu/medicine/pediatrics/students/current/third-year; here you will find curriculum requirements inlcuding CLIPP and ethics & professionalism cases: www.med-u.org.
WRITE Students will earn 3 weeks of Pediatrics credit during the on-site portion of the WRITE program while working with the family medicine preceptors and/or a faculty-appointed pediatrician in the community. Students will be given a Peds Clerkship Manual which covers pediatric clerkship requirements, some of which students will complete during their first 3 weeks of their inpatient pediatric rotation. Students are responsible for submitting final pediatric requirements to Carla Salldin by time of end of WRITE session. Students are asked to complete all CLIPP cases by time of pediatric exam.
The student will be responsible for successfully completing a Pediatrics exam at the WRITE Site, which will be scheduled about mid-way through WRITE--this is ONLINE and will need to be proctored--more details to come. The exam is based on CLIPP cases.
Preceptor & Student Resources:
Click here to view the PDF of the Clinical Encounters: Pediatric 3rd Year Write Clerkship Form (PDF)
Click here to view the PDF of the Peds Mid-End Clerkship Review Form (PDF)
Click here to view the PDF of the Peds Educational Objectives (PDF): it is suggested that students and preceptors review this guide to determine if basic pediatric competencies are being met.
Please contact the Pediatric WWAMI Program Coordinator with any questions about your pediatric WRITE requirements by e-mail Carla.firstname.lastname@example.org or by phone at (206) 987-2063.
The Department of Psychiatry Clerkship web site is at http://depts.washington.edu/psyclerk/; here you will find Forms (grading, Mini-Cex, and evaluation), cases, clerkship objectives, and requirements. There is a WRITE tab on the website that lists all of the requirements that the student will have completed prior to starting at their WRITE site. Check the Psychiatry web site for links to lectures and information about electives.
Prior to students' departure to their WRITE sites, students will have had three weeks of inpatient psychiatry, and will have completed their core requirements. The student will receive the program requirements and information during the first three weeks of the rotation.
Some students will have taken their PBSCI exam at the end of the first 3 weeks of their inpatient rotation--prior to going to their WRITE Site. Others will need to schedule to take their exam while at their WRITE site: Students will need to schedule a time with their preceptor to proctor the exam and work with the Department of Psychiatry to have the exam sent to the site.
The primary goal of the Psych experience is for students to see patients with psychiatric issues in the outpatient setting with longitudinal exposure and to increase their comfort level with this patient population. WRITE Students earn a total of six weeks of credit by merging the three-week evaluation from the formal clerkship site and the experience of seeing and working with patients with psychiatric or behavioral problems at the WRITE Site.