Dear Class of 2026,
Welcome to Phase 3 of your medical education! We know many of you are excited to begin your senior rotations and many of you are studying for your Step 2 exam. We want to ensure you have the resources needed over the coming months as you navigate the exciting year ahead.
Many students arriving to Phase 3 are adjusting to increased expectations. You have come a long way since beginning your clerkships and have amassed considerable knowledge. You also have much to accomplish to begin practicing medicine on your first day of residency just months from now.
Your preceptors will expect you to:
- Assess your patients independently. Faculty and residents will expect you to obtain an appropriate history and perform a relevant physical examination on all patients under your care.
- Develop an accurate differential diagnosis and specifically mention the differential in oral presentations and written notes.
- Propose an appropriate management plan. Your plan should be directly related to your differential diagnosis and incorporate the patient’s values and preferences. It should include not just the diagnostic plan but also the management of symptoms, follow-up, and social determinants of care.
- Perform tasks under physician supervision: To the maximal extent permitted by existing systems and in preparation for your intern and residency years, you should enter orders, write notes, and perform appropriate procedures, consultations, patient education, and discharge planning under physician supervision in all your patient encounters.
Perhaps most importantly, your preceptors will expect you to identify your own learning goals and gaps as you prepare for your transition to residency. Not only are you all preparing for different career pathways, but each student has unique strengths and challenges. Participate in as many patient encounters as you can, read about your patients and interesting cases, and push yourself to learn as much as you can over the next few months.
We hope you find this a fulfilling and exciting year of your training as you continue to develop your role in the healthcare team and hone your skills.
Just in case you need it, the Handbook has all the policies and details that are relevant for you. Here are some policies to highlight:
Graduation Requirements
Please review the Graduation Requirements for Phase 3. If you want to learn more about the Phase 3 required rotations, you can also learn more about them here.
Grading & Exams
- Grade Policy (Grade Policy for Phases 2 and 3) All Phase 3 rotations are graded Satisfactory/Fail (S/F), including Sub-Internships, Critical Care Selectives, Radiology, Emergency Medicine, Electives and Transitions 3. Please review the specific syllabus for details about the grading breakdown for each clerkship/course/selective. For any questions, reach out to your clerkship/course/selective directors.
- Phase 3 NBME Exams: The only Phase 3 NBME exam is the Emergency Medicine Clerkship. During EM, the NBME exam will take place during the end of the rotation and is typically offered on two separate days to provide some schedule flexibility.
EM Clerkship Information
- Please enter your required EM orientation, simulation, and exam days into your calendar immediately to avoid schedule conflicts in the future.
- In the EM Clerkship, there will be a required mid-rotation practice NBME exam. This exam will help you gauge where you are in preparation for the final NBME exam.
Time Away
- Time Away for Residency Interviews: IU School of Medicine allows students to reschedule educational activities, whenever possible, for residency interviews. Our ability to accommodate schedule changes depends on effective and timely communication. Please review the IUSM Guide to Time Away for Phase 3 for guidance on scheduling flexibility for interviews.
Travel Guidelines
Should you need to travel to a different campus for a required Clerkship/Selective or an Elective, please review the Phase 3 Scheduling Guidelines and the MSE Travel Guidelines which include information regarding Housing, Mileage Reimbursement, and Parking.
Noteworthy Accreditation Standards/Policies specific to Phase 3
- Work hours: Medical students on clinical rotations must not exceed an 80-hour work week averaged over a 4-week period. Students must be provided with at least one day off per seven-day period averaged over 4 weeks. These restrictions are consistent with ACGME policies in residency and are best practice. Work hour restrictions apply to both electives and required rotations; however, you only need to log work hours in MedHub during your EM, Critical Care, and Sub-I rotations. Here is a tutorial on how to log in work hours.
- Supervision and Scope of Practice Policy: Any concern about inappropriate supervision during your rotations can be reported here, and someone will follow up with you.
- Time Away Policy: Please review this policy for questions about absences from clinical rotations and interview requests. You can also access the Time Away Request Form.
- Conflicts of Interest in Supervision and Evaluation: Students should not be evaluated by any individual who has a current or prior relationship that could reasonably be perceived as a conflict of interest. This includes familial relations, currently or previously providing medical or mental healthcare to the student, or if either party feels that there is a conflict of interest. Students who believe there may be a conflict of interest in assessment should contact the Clerkship/Selective/Elective Director immediately upon discovering the issue. Any resulting issues will be handled with confidentiality and respect for all parties.
- Learning Environment AND Mistreatment Policy & Procedures: We value fostering a positive learning environment throughout your entire medical training experience. We know you are probably familiar with this policy and procedure for reporting mistreatment issues, but if ANY issues occur, please discuss it with someone for assistance and support.
- Non-Mistreatment Concerns Reporting: Students may also report non-mistreatment-related concerns and incidents in the learning environment. Concerns can be reported anonymously; per IU policy, retaliation against anyone submitting a report is strictly prohibited. Student concerns that are not related to mistreatment may include:
- Involvement of a student’s prior healthcare provider in teaching/assessment
- Inadequate clinical supervision
- Lack of access to secure storage, study, or relaxation spaces in academic or clinical settings
- Excessive work hours
- Too many learners on clinical experiences
- Failure to excuse for necessary health appointments
- Microaggressions or bias in curricular content.
- Infectious Disease and Environmental Hazards Policy (i.e., Needlestick): Please review this policy addressing how to effectively manage student exposure to infectious and environmental hazards.
Always check with your specific clerkship/selective/elective leadership team for clarification about any of the above policies and procedures as they relate to their clerkship/selective/elective. If you have any areas that need clarification, please do not hesitate to reach out to your Lead Advisors, Student Affairs Deans, or Dr. Megan Christman for assistance. Any general questions can also be submitted to AskMSE.
On behalf of the entire Phase 3 Curriculum Team, we hope this is a successful and exciting year for you. We are excited to help you grow into your roles as outstanding physicians!
Megan Christman DO, FACOG (She/her/hers)
Assistant Dean of Curriculum, Director of Phase 3
Assistant Professor of Obstetrics and Gynecology
