Required MD Clerkship Form

Please complete form for all required MD clerkships.

* indicates required fields.

Preparer Information


Name *





Course Information


















Method(s) of Assessment of Student Performance *

CLERKSHIP DESCRIPTION



CLERKSHIP OBJECTIVES

The clerkship objectives will not be included in the catalog but will be used by the Office of Medical Education for review of the clerkship and its content and may be used for reporting purposes. Objectives should be measurable, student focused and linked to the overall objectives of the School of Medicine.


Please indicate which SOM competencies are addressed through the objectives listed above *

REQUIRED APPROVAL


Approval *