Primary Intern Manual

7/23/2019 Primary Intern Manual

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PRIMARY INTERN MANUALClinic IV, V & VI

CLE404, 412, 450

CCNM Teaching Clinics2013-2014



2

N ATUROPATHIC DOCTOR’S O ATH

I dedicate myself to the service of humanity

as a practitioner of the art and science of naturopathic medicine.

By precept, education and example, I will assist

and encourage others to strengthen their health,

reduce risks for disease, and preserve the health of our planet

for ourselves and future generations.

I will continually endeavor to improve my abilities.

I will conduct my life and practice of naturopathic medicinewith integrity and freedom from prejudice.

I will keep confident what should not be divulged.

I will honour the principles of naturopathic medicine:

First, to do no harm.

To co-operate with the healing powers of nature.

To address the fundamental causes of disease.

To heal the whole person through individualized treatment.

To teach the principles of healthy living and preventive medicine.

With my whole heart, before these witnesses,

as a Doctor of Naturopathic Medicine,

I pledge to remain true to this oath.



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The Canadian College of Naturopathic Medicine

Program Mission Statement

Through excellence in health education, clinical services and research that integrate

mind, body and spirit, the Canadian College of Naturopathic Medicine program

develops primary care doctors accomplished in the art and practice of naturopathic

medicine.

Graduates of the Canadian College of Naturopathic Medicine's naturopathic

medicine program will be able to:

1. Integrate naturopathic philosophy and principles with medical knowledge in the care

of patients.2. Educate patients and the public in health promotion, and disease prevention.

3. Manage the underlying spiritual, social, mental and physical causes of disease.

4. Practice in a manner that exemplifies professionalism, strong ethics and a

commitment to the principles of naturopathic medicine.

5. Communicate effectively with patients.

6. Appraise and apply research in treating patients.

7. Integrate biomedical with clinical science knowledge in the assessment, diagnosis,

and management of patients.

8. Utilize naturopathic therapeutics in the individualized care of patients including but

not limited to:- Asian Medicine

- Botanical Medicine

- Clinical Nutrition

- Counseling & Health Psychology

- Homeopathic Medicine

- Lifestyle Modification

- Nature Cure

- Pharmaceuticals

- Physical Medicine

9.

Identify the need for urgent and emergent health care and direct appropriateresolution.

10. Establish and manage a naturopathic practice.

11. Manage chronic disease.

12. Demonstrate leadership in health advocacy and environmental stewardship.

13. Collaborate effectively and work in partnership with other healthcare practitioners.

14. Demonstrate commitment to the advancement of the naturopathic profession.



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Table of Contents

CLINICAL EDUCATION OVERVIEW ................................................................................................. 5

ADMINISTRATIVE ASSISTANCE ............................................................................................................. 5

COMMUNICATION ............................................................................................................................. 5

CONTACT LIST ............................................................................................................................ 7

CLE404/412/450 COURSE EVALUATIONS, 2013-14 .................................................................. 10

MINIMUM SEMESTER REQUIREMENTS, 2013-14 ......................................................................... 11

12-MONTH SUMMARY OF 2013-14 TOTAL REQUIREMENTS FOR CLE404/412/450 ................................. 13

Clinic Hours ............................................................................................................................... 14

Primary Visits ............................................................................................................................. 14

Global Assessment of a Patient Interaction ........................................................................... 15

MYMOPs .................................................................................................................................... 17

Primary Health Screen ................................................................................................................ 17

Digital Rectal Prostate Examinations ............................................................................................ 18

Laboratory Rotation .................................................................................................................... 19

RSNC LABORATORY MEDICINE CLINICAL ROTATION .................................................................... 20 Acupuncture ............................................................................................................................... 23

Botanical Medicine ..................................................................................................................... 23

Acute Homeopathic Prescriptions ................................................................................................ 23

Constitutional Homeopathic Prescriptions .................................................................................... 24

Naturopathic Manipulations ......................................................................................................... 24

Constitutional Hydrotherapy ........................................................................................................ 24

Hydrotherapy, general ................................................................................................................ 25

CONSULTANTS ............................................................................................................................. 26

1) Health Psychology Consultant, David Dennis & Allison Creech, ND ............................................ 26

2) Primary Care Consultant, Dr. Michael Salsberg MD .................................................................. 26

3) Practice Management Consultants, Nadine Cyr ND & Erin Truscott-Brock ND ............................ 26

Practice Management Portfolio ............................................................................................. 27

4) Optional Consults Available ..................................................................................................... 27

CASE MANAGEMENT FORMS (CMFS) .................................................................................................. 27

Case Management Rubric, 2013-14 ............................................................................................ 29

EVALUATIONS .......................................................................................................................... 30

MIDTERM PICE EVALUATION ....................................................................................................... 30

FINAL PICE EVALUATION ............................................................................................................. 31

PRIMARY INTERN COMPETENCY EVALUATIONS: FLOW CHART ..................................................... 32

EXTERNSHIP PROGRAM ............................................................................................................. 39

DEADLINES FOR APPLICATION ........................................................................................................... 39

CLE100, CLE201 AND CLE310 ................................................................................................. 40

MONTHLY RECORD KEEPING ..................................................................................................... 41

POLICY ON CONVOCATION ........................................................................................................ 41



5

Clinical Education Overview

This curriculum is designed for students entering their final year of study at the

Canadian College of Naturopathic Medicine. The Primary Internship is comprised of 3

separate courses, CLE40, CLE412, and CLE450 each of which must be passed in

order to graduate.

Academic Clinic Committee (ACC)

The Academic Clinic Committee consists of the Dean, the Chief Naturopathic Medical

Officer (CNMO), the Associate Dean, Clinical Education (ADCE), the Associate Dean,

Academic Delivery (ADAD), the Associate Dean, Curriculum and Residency Program

(ADCR), the Associate Director, Clinic Services (ADCS), the Academic Coordinator and

the Privacy Officer.

This committee formally deals with all issues relating to clinic operations and clinical

education, including student discipline issues. All special requests outside normalpolicies and procedures are subject to approval by this committee.

Administrative Assistance

All questions regarding Clinic Education courses and requirements should first be

directed to the Office of Clinical Education, Clinical Education Administrative Assistant,

ext. 241, [email protected]. All clinic paperwork is to be submitted on Moodle or in the

OCE mailbox located in the clinic Student Business Centre.

COMMUNICATION

1. Moodle is our main avenue for daily communication. Communications will be

primarily posted to the CLINIC FORMS AND RESOURCES page, and occasionally

in the CLE404, CLE412 and CLE450 course shells.



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2. Questions regarding Clinical Education policies & procedures, important dates,

and the completion and submission of paperwork should be addresses to the

Clinical Education Administrative Assistant, ext 241, [email protected].

3. The Associate Dean, Clinical Education and the Associate Director, Clinical

Services hold weekly meetings with the 4th yr. Clinic Class Reps to addressissues brought forward by interns and to convey information to the class.

4. Appointments with the Associate Dean, Clinical Education may be made through

the Clinical Education Administrative Assistant, x241, [email protected].



7

CONTACT LIST Administration

x220 Melanie Katovich Academic Administrative Coordinator

X232 Rachel Miranda Clinical Education Administrative Assistant [CEAA]

X397 Mitchel l Zeifman, BSc, ND Associate Dean, Clinical Education [ADCE]

x235 Jonathan Prousky, ND, MSc Chief Naturopathic Medical Officer [CNMO]

Full-time Clinic Faculty

x336 Nadia Bakir, BSc, ND, MSc Academic/Clinic Faculty

x275 Kimberlee Blyden-Taylor, ND Academic/Clinic Faculty

x321 Adam Gratton, ND Academic/Clinic Faculty

x284 Alexander Hall, ND Clinic Faculty

x392 Hal Huff, BA, ND, MSc Clinic Faculty

x253 Afsoun Khalilli, ND Clinic Faculty

x280 Dan Lander, ND, FABNO Academic/Clinic Faculty

x227 Paul Saunders, PhD, ND, DHANP Academic/Clinic Faculty

x393 Leslie Solomonian, ND Academic/Clinic Faculty

x377 Jonathan Tokiwa, RN, ND, LAc Academic/Clinic Faculty

x298 Zeynep Uraz, ND Academic/Clinic Faculty

X303 Ellen Wong, ND Academic/Clinic Faculty

Feature 980+494 Melvia Agbeko College Resident , Second Year

Feature 980+492 Zain Ladha College Resident , Second Year

x297 Elaine Lewis College Research Resident , Second Year

Feature 980+493 Kristi Prince College Resident, Second Year

Feature 980+369 Maria Shapoval, ND College Research Resident , Outgoing Second Year

Feature 980+379 Vanessa Youssef, ND College Resident , Outgoing Second Year

Feature 980+399 Mark Fontes, ND College Resident , Outgoing Second Year

Feature 980+389 Christopher Roberts, ND College Resident , Outgoing Second Year

Part-time Clinic Faculty Kristina Brooks, ND Sejal Parikh-Shah, ND, LAc

Shelley Burns, ND Poonam Patel, ND

Barbara Cowan, ND Rita Patel, BSc, ND, FSHM, LAc

Paul Davis, BSc (Hons), ND Erin Psota, ND

Ken Dunk, DC, ND, FCAH Rajesh Ragbir, ND

Kerri Fullerton, ND Romi Raina, ND

Alexia Georgousis, ND Pat Rennie, ND

Matthew Gowan, ND Michelle Richea, ND

Lowell Greib, MSc, ND Anne Salsberg, ND

Cyndi Gilbert, ND Jill Shainhouse, ND, FABNO

Nicole Henry, ND Onkar Singh, ND

Payam Kiani, ND Susan Slipacoff, ND

Ajay Lad, ND Tracey Teasdale, ND

Carole Ma, ND Peter Tebruegge, RMT, ND

Tracy Malone, ND Erin Truscott-Brock, ND

Sean McConnell, ND Teresa Tsui, ND, MSc

Louise McCrindle, ND Pilar Villegas, ND

Cristina Meffe, ND Alan Vu, ND

Caroline Meyer, BASc (Hon), ND Heidi Willms, ND

Rupi Mitha, ND Saveria (Rena) Zambri, ND, FCAH



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Faculty Consultants David Dennis, ND Health Psychology

Allison Creech, ND Health Psychology

Michael Salsberg, FCFP, MD Primary Care

x215 Neemez Kassam, ND Asian Medicine

Lowell Greib, ND Physical Medicine

Nadine Cyr, ND Practice Management

Erin Truscott-Brock, ND Practice Management



9

CLINICAL EDUCATION

2013-2014

CCNM Teaching Clinics



10

Pass on at least

3 of 4

Final SemesterEvaluations

Does NOT Pass

at least 3 of 4Final Semester

Evaluations

CLE404/412/450 COURSE E VALUATIONS, 2013-14

Each course is P/F based on: 1) Achieving a pass on 3 out of 4 Final Semester Evaluations, AND

2) Fulfilling the Minimum Semester Requirements as listed below.

+

+

+

1) FINAL SEMESTER E VALUATIONS Each term 3 out of 4 Final Semester Evaluations must be passed to pass the course. If more

than 1 Final Evaluation is not passed in any one term, the intern receives an F (fail) and must

repeat the entirety of the clinic course (CLE404, 412 or 450). Patient visits, hours, and

modality “numbers”, as well as case management forms submitted during a failed term, will

not be credited towards a subsequent term.

A failing evaluation in either the midterm or final evaluation, while not initiating a term fail,

remains a cause for investigation. Clinical interns with a fail on any evaluation can expect

increased attention from supervisors, advisor and Associate Dean. The ultimate goal being

the identification of the intern’s area(s) of weakness and providing support for the successfulcompletion of the clinical rotation.

Pgs. 28-36 of this Manual provide details on Evaluations.

2) MINIMUM SEMESTER REQUIREMENTS Each term, the minimum semester requirements listed below must be achieved in order to

pass the course. If an intern passes 3 out of 4 Final Semester Evaluations but does not

complete the minimum semester requirements by term end, the intern will receive an INC

Minimum

Semester

RequirementsAchieved

Minimum

SemesterRequirements

Achieved

Minimum

SemesterRequirements

NOT

Achieved

PASS

FAIL

Pass on at least

3 of 4Final Semester

Evaluations

INC



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(incomplete). The intern will then have one additional month (16 clinic shifts) in which to

complete the minimum semester requirements, at which point the INC may be changed to a

Pass. If the intern does not complete the minimum semester requirements within the

extension month the intern will receive a Fail in the course. Additional remedial activity will be

required of students who are incomplete in greater than 10% of one requirement or of

multiple, different requirements. Remedial activity is set by the Associate Dean, ClinicalEducation and may include focused research assignments, tutoring or a combination

activities designed to address the intern’s assessed deficiencies. Clinical interns are provided

and extra 4 weeks (16 shifts) to meet term requirements and complete remedial activity. If

the intern is unable to meet the minimum semester requirements and remedial activities

prescribed by the second extension deadline, they will be required to repeat the term failed.

All clinical activity and credits from the failed term will be erased and the student will be

assessed again by the standards of the term being repeated.

Term assignments, such as Case Management Forms (CMFs) and reflection assignments, will

not be granted the month extension beyond the term deadlines. Late assignments will not be

accepted for term credit without remediation, as determined by the Associate Dean, Clinical

Education. Further. Further, late or incomplete assignments may negatively impact the finalevaluation of the clinical intern due to poor representation of certain clinical competencies,

such as the Professionalism and Ethics competency. If a clinical intern does not apply for or

receive an extension for a late assignment, the intern will receive a fail for the assignment

and an INC for the term. This grade may be reversed once all remedial assignments are

completed within the time frame for extensions specified.

MINIMUM SEMESTER REQUIREMENTS, 2013-14*Numbers in excess of the minimum are applied to the subsequent term

CLE404 (1st

term): minimum requirements* Case Management forms PASSED4 (1 per supervisor)

General Screening Physical Exams4

Primary Health Screen 4

Total Patient visits 65

Global Assessment of Patient Interaction1

Advisor meeting 1

CLE412 (2nd term): minimum requirements*

Global Assessment of Patient Interaction1

Case Management forms PASSED 4 (1 per supervisor) General Screening Physical Exams4


Breast Exams 1

Total Patient visits: 105

Female Pelvic Exam 1

DRE 1



12

Practice Management Consults1

Advisor meeting 1

CLE450 (3rd term): minimum requirements*

Global Assessment of Patient Interaction 1

Case Management forms PASSED: 4 (1 per supervisor) General Screening Physical Exams:4


Breast Exams 1

Total Patient visits: 110

Female Pelvic Exam 1

DRE 1

Practice Management Portfolio1

Advisor Meeting 1

Requirements which may be completed anytime during CLE 404/412/450

or required for completion of program requirements.

If incomplete, the Intern will not pass CLE450 until all requirements and any

prescribed remedial work have been completed .

Primary Care Consult 1

Venipuncture 10

Urinalysis 10

B12 injections 10

Acupuncture 35

Botanical prescriptions 20; min. 15 must be 3-herb combos. Manipulations6 cervical/ 6 thoracic/ 6 lumbar

Acute Homeopathic Prescriptions5

Constitutional Homeopathic prescriptions5

Constitutional Hydrotherapy 6

Hydrotherapy, general10

Total clinic hours 1032

Secondary Clinical Patient Contacts60 (min)

Total Secondary Clinic Contacts 80

(Accumulated in clinic and CLE courses)

Total Preceptor Hours/Contacts100/100



13

12-month SUMMARY of 2013-14 TOTAL Requirements for CLE404/412/450

Clinic Hours & Visits Laboratory

RSNC, Satellite &/or Externship

hours

1032 Urinalyses 10

Primary Visits 280 Venipuncture 10

Physical Exams Required Consults

General Screening Physical Exams 12 Digital Rectal Prostate Exams 2

Preventative Health Screen 12 Primary Care 1

Breast Examinations 2 Practice Management 1

Female Pelvic Examinations 2 Advisor Meetings 3

Modalities Assignments

Acupuncture 35 Case Management Forms 12

Botanical Prescriptions 20 Botanical Dispensary Shifts 2

Acute Homeopathic Prescriptions 5 Laboratory Shifts 4

Constitutional Homeopathic pres.’s 5 Laboratory Assignment 1

Manipulations 18 Evaluations

Hydrotherapy, general 10 Midterm PICE Forms 4

Constitutional Hydrotherapy 6 Final PICE Forms 4

B12 injections 10 Practice Management Portfolio 1

Global Assessment of a PatientInteraction

3



14

CLINIC HOURS

The minimum total number of clinic hours required is 1032*. These hours

may be accumulated throughout CLE404/412/450, and have no specific required

semester totals.

Hours are accumulated on RSNC shifts, satellite clinic shifts, and at Externship

placements. A maximum of 103 hours may be counted from an Externship

placement. If additional hours (more than 103) are accumulated at an externship

placement they will be counted as preceptor hours. (NB: you may not credit

externship hours as preceptor hours before the 103 maximum is achieved.)

Clinic hours are recorded on the “Clinic Attendance Record” and must be signed by

the Supervising doctor during the shift; hours may not be signed at a later date.

Unsigned hours will not be counted towards requirements.

*Please note that hours in excess of the minimum requirement cannot be “banked ”,

i.e. applied towards additional vacation.

PRIMARY VISITS

The minimum total number of patient visits required is 280 . These are divided

per semester:

CLE350 (1st term) = 65 Visits

CLE412 (2nd term) = 105 Visits

CLE450 (3rd term) = 110 Visits

This includes patients seen at RSNC, satellite clinics, and at externship placements.

A maximum of 52 patient visits may be counted from an Externship placement.

Please note that student “exchanges” of treatments do not count towards this total.

SECONDARY CLINICAL CONTACTS

The minimum total number of total secondary clinical contacts from allyears is 80. It is estimated that most students will need a minimum of 60 secondary

clinical contacts in the final clinical year.

Secondary clinical contacts constitute any clinically-based interaction with a patient

that is not performed in a primate intern role. This includes secondary observation of

a full or partial visit, IV shift activity with patients, secondary activity with hydrotherapy



15

treatments (such as peat baths and saunas), venipuncture and intramuscular

injections (when not the primary clinician). Secondary clinical contacts may be

collected at any time over the three terms. It is the ultimate responsibility of each

intern to plan for secondary clinical contacts over the course of the clinical year. This

may be done by requesting to observe with a colleague or a supervisor when not

booked with patients on a regular shift or an on-call shift.

Secondary Clinical Contacts are tracked using the Secondary Clinical Contact Record

(found on Moodle). A supervisor must sign off for each patient seen as a secondary.

As with clinic hours, supervisors must sign the Clinical Contact Record during the

shift; unsigned hours or hours signed at a later date will not be counted towards

requirements.

Global Assessment of a Patient Interaction

To provide effective patient-centered care, interns are expected to focus on certainkey objectives in every patient visit. The Global Assessment of a Patient Interaction

allows for a structured assessment of key competencies expected to develop over

the course of the clinical year. Supervisors will use the assessment to provide

formative feedback on patient rapport, goal setting and other skills listed below.

Interns are expected to request at least one Global Assessment of a Patient

Interaction from at least one supervisor per term. Supervising doctors will be looking

for a progression of skills from one term to the next. This feedback will be provided

to you and the practice management consultant to assist you in building upon these

skills.



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Global Assessment of a Patient Interaction

Completed by:_______________________________________________________________

Name (please print) Date

Student:_____________________________________________________________________

Did this student demonstrate the following clinical competencies? Base your answer on your overall

impression of the performance.

History Taking: Rapport Skills:

Focused enquiry and information

gathering method

Logical sequence of questions

Avoids leading questions/ biasing

patients response

Avoids jumping to premature

conclusions

Efficient use of time

Listens carefully, puts patient at ease

Receptive atmosphere

Good eye contact

Appropriate posture

Conveys a sense of confidence

Is empathic and makes

affirming/legitimizing statements

Is neither rude, arrogant, nor

patronizing

Interviewing Skills:

Has an organized approach

Uses words patient can understand

Uses open-ended and closed questions appropriately Asks one question at a time

Uses facilitation techniques, e.g. silence, repetition, etc.

Communication skills

Establishes a clear agenda for the visit

Communication of provisional diagnosis

Communication of prognosis and short term plan

Communication of initial management plan (most patients should receive

some suggestions on how to manage their concern on their first visit)

Communication of next appointement date

PLEASE PROVIDE DETAILED COMMENTS :

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

____________________________________________

Which of the following competencies were demonstrated?



17

MYMOPS

The Measure Yourself Medical Outcome Profile (MYMOP) is a standardized tracking

questionnaire that is employed in the RSNC to track and measure patient outcomes.

MYMOPs are not an absolute clinic requirement; however, they represent a main

tracking tool and are recommended to be used with every patient. MYMOP tracking

(at least three data points) will be required for every CMF submitted. Formore information on this measurement tool, visit the website at

http://sites.pcmd.ac.uk/mymop/index.php?c=intro.

MYMOPs may be done at every patient visit . There are no restrictions to use.

This tool for measuring treatment outcomes does not become clinically useful until a

minimum of 5 are done on any one case. Interns are encouraged to consistently

apply this tracking tool with patients and to utilize the results over time to assess

patient outcomes.

General Screening Physical Examinations

The minimum total number of General Screening Physical exams required is

12.

These are divided per semester:

CLE404 (1st term) = 4

CLE412 (2nd term) = 4

CLE450 (3rd term) = 4

Primary Health Screen

The primary health screen is a tool created to assist in tracking and informing

patients of age-specific health screening for preventative health. To complete the

Primary Health Screen the intern must complete all relevant points of the General

Screening Physical Examination & Required Testing Form and update the Cumulative

Patient Profile form for the patient. Demonstrating the completion of these elements

to your clinic supervisor will qualify for a Primary Health Screen credit.

The minimum total number of Patient Health Screens required is 12.These are divided per semester:

CLE404 (1st term) = 4





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Breast Examinations

The total number of breast exams required is 2 . These are divided per

semester:



All breast examinations must be performed entirely under supervision. Successfulbreast examinations are based on competency of examination, patient

communication, assessment of examination findings and patient recommendations

provided based on findings.

Female Pelvic Examinations

The total number of gynecological exams required is 2 . These are divided per

semester:

CLE412 (2nd term) = 1 CLE450 (3rd term) = 1

All gynecological examinations must be performed entirely under supervision.

Successful female pelvic examinations are based on competency of examination,

patient communication, assessment of examination findings and patient

recommendations provided based on findings.

If the exam has not been accomplished with a patient one month prior to the

requirement due date, you will have the option of performing the exam with a

standardized model.

Digital Rectal Prostate Examinations

The total number of digital rectal prostate exams required is 2 . These are

divided per semester:



All male genital & prostate examinations must be performed entirely under

supervision. Successful digital rectal prostate examinations are based on

competency of examination, patient communication, assessment of examination

findings and patient recommendations provided based on findings.

If the exam has not been accomplished with a patient one month prior to therequirement due date, you will have the option of performing the exam with a

standardized model.



19

Laboratory Rotation

The total number of Urinalyses required is 10 .

The total number of Venipunctures required is 10.

Urinalyses and venipunctures may be accumulated throughout CLE404/412/450,

and have no specific required semester totals .

Prior to attending your initial Laboratory Rotation, interns are expected to have

read and be familiar with the RSNC Lab Manual. Interns that are not prepared

for the laboratory shift will be given remedial work to complete.

Laboratory Assignment

Over the course of your Lab DI shifts, you will complete the Laboratory

Assignment with the Medical Lab Technologist. To pass the Laboratory

Assignment, you must achieve competency in all sections of the assignment

by the end of your assigned Lab shifts. If you have not passed thisassignment by that time, additional remediation shift(s) may be assigned.

Laboratory Shifts

Interns are scheduled for a minimum of 4 Lab DI (Duty Intern) shifts during

CLE404/412/450. The Duty Intern (DI) Schedule is posted on Moodle (On the

Clinic Forms and Resources page) as well as on the 4 th Year Clinic Bulletin Board by

the File Room.

Interns are expected to attend all scheduled Lab DI shifts, regardless of whether

the minimum number of shifts and/or the Laboratory Assignment have been

completed.



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RSNC LABORATORY MEDICINE CLINICAL ROTATIONChecklist of Competencies

Student name: _______________________________________ (please print)

Student ID #: _________________________

Date: ______________.

I have read the Health and Safety and Specimen Collection chapters in the RSNC

Laboratory Manual

_____________________________________

(Student signature)

Requirement Lab Supervisor name (print) & signature

Can describe Universal Precautions

Can describe RSNC Needlestick Injury ProtocolCan describe OSHA regulations for spill clean-up

In order to complete and pass the RSNC Laboratory Clinical Rotation, the intern must

Achieve Competency in all sections of the checklist.

IHL ROTATION

Time Clinical Reception name (print) &

signature

Time in

Time out

IHL Indications Procedure Interpretation Case

Management

Overall

Blood glucose

test(glucometer)A /C P/C F 1

Blood typing A /C P/C F

ESR A /C P/C F

Zinc tally A /C P/C F

Spirometry test A /C P/C F

Nebulizer treatment A /C P/C F

Hair analysis A /C P/C F

Urinalysis Performed dipstick proficiently Yes No

Described patient instructions for 24-hour urine collection

Yes No

1 A/C : Achieved Competency P/C : Partial Competency F: Fail



21

RSNC LABORATORY MEDICINE CLINICAL ROTATIONChecklist of Competencies (cont’d)

Described sample preparation for:

Skin scrape

Throat swab

Sputum

Vaginal swab

Yes No

Yes No

Yes No

Yes No

Completion of IHL checklist Yes No

Lab Supervisor signature:

(to be signed at the end of the clinical shift)

GDL ROTATION

Time Clinic Reception name (print) &signature

Time in

Time out

GDL Indications Procedure Interpretation Case

Management

Overall

CBC A /C P/C FThyroid panel A /C P/C F

Creatinine (serum) A /C P/C F

eGFR A /C P/C F

Zinc A /C P/C F

Fasting glucose A /C P/C F

Hemoglobin A1C A /C P/C F

INR A /C P/C F

Cholesterol panel A /C P/C F

Ova and Parasites

(no stool collection

required only a

discussion with Clinic

Faculty)

A /C P/C F

Urea breath test A /C P/C F

Pap Smear A /C P/C F

Homocysteine A /C P/C FHIV A /C P/C F

Microalbumin and

Creatinine ratio

A /C P/C F



22

RSNC LABORATORY MEDICINE CLINICAL ROTATIONChecklist of Competencies (cont’d)

Venipuncture proficiency:

Good selection of vein A/C P/C F

Professional manner A/C P/C F

Correct order of removal A/C P/C F

(Tourniquet, tube, needle )

Butterfly draw (one draw) A/C P/C F

Completion of GDL checklist Yes No

Lab Supervisor signature: _____________________________________________(To be signed at the end of the clinical shift)

RSNC Laboratory Medicine Clinical Rotation Complete Incomplete

Student signature: ___________________________________________

Laboratory Supervisor signature: _______________________________________

Date: ______________________



23

A CUPUNCTURE

The minimum total number of acupuncture treatments required is 35.

Acupuncture treatments may be accumulated throughout CLE404/412/450, and

have no specific required semester totals .

Once an intern has performed a minimum total of 5 acupuncture treatments, yoursupervisors have the option of not being present in the treatment room for the

insertion of acupuncture needles. This is at the discretion of each individual

supervisor and requires “sign-off” by each supervisor on the appropriate form (found

in the supervisor’s shift binder).

Botanical Medicine

The total number of Botanical Prescriptions required is 20 . Botanical

prescriptions may be accumulated CLE404/412/450, and have no specific

required semester totals .

A minimum of 15 (of 20) prescriptions must contain 3 or more botanical herbs

(liquid or dried) and be filled at the RSNC Dispensary (or equivalent compounding

pharmacy). A maximum of 5 (of 20) botanical prescriptions may be solid extracts,

single or 2 herb prescriptions, ready-made combinations, teas or powders (these are

identified as “other botanical prescriptions ”).

Please Note : Repeats of botanical prescriptions (with the same patient) will not be

credited towards requirement numbers.

Acute Homeopathic Prescriptions

The total number of acute homeopathic prescriptions required is 5.

These prescriptions may be accumulated throughout CLE404/412/450, and have no

specific required semester totals.

Botanical Compounding Shifts

All Interns are scheduled for a minimum of 2 “Compounding DI” (Duty Intern) shifts

during CLE404/412/450. The Duty Intern (DI) Schedule is posted on Moodle (on

the “Clinic Forms and Resources” page) as well as on the 4th Year Clinic Bulletin

Board.

Interns are expected to attend all scheduled Compounding DI shifts, regardless of

whether the minimum number of shifts have been completed.



24

To be credited for an acute homeopathic prescription the prescribing intern must

demonstrate a reasonable differential list of remedies based on the signs and

symptoms presented, selected through repertorization and/or clinically appropriate

reference material. Rationalization for final prescription, potency and posology must

be presented for credit to be awarded.

Please Note : An acute homeopathic credit is not given for re-dosing an acute

prescription, with or without a change of potency.

Constitutional Homeopathic Prescriptions

The total number of constitutional homeopathic prescriptions required is 5 .

These prescriptions may be accumulated throughout CLE404/412/450, and have no

specific required semester totals .

To be credited for a constitutional homeopathic prescription, the following must be

included in the patient file: Credit cannot be granted without this supporting material.

Detailed patient intake

Rubrics, print-out of repertorization, determination of miasm, family, series,

stage, etc. as appropriate to the case

DDX of top remedies (3-5), with pros & cons for each

Rationalization for final prescription, potency, and posology

Please Note : A constitutional homeopathic credit is not given for re-dosing a

constitutional prescription, with or without a change of potency, or for a previous

constitutional prescription dosed acutely.

Naturopathic Manipulations

The minimum total number of manipulations required is 18 = 6 cervical, 6

thoracic, and 6 lumbar. These adjustments may be accumulated throughout

CLE404/412/450 and have no specific required semester totals .

Constitutional Hydrotherapy

The minimum total number of Constitutional Hydrotherapy prescriptions

required is 6. One constitutional hydrotherapy treatment is considered a

“prescription”. These prescriptions may be accumulated throughout

CLE404/412/450 and have no specific required semester totals.



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Constitutional hydrotherapy is generally prescribed as a series of treatments. A

Constitutional Hydrotherapy Patient Treatment Record should be completed for each

series of treatments and placed in the patient’s file. For more details, see the

Hydrotherapy Manual on the Moodle Clinic Forms and Resources page.

Hydrotherapy, general

The minimum total number of Hydrotherapy prescriptions required is 10.

These prescriptions may be accumulated throughout CLE04/412/450 and have no

specific required semester totals .

Examples include, but are not limited to:

Sauna Nasal lavage

Full or partial immersion peat baths Sitz bath

Poultices Steam inhalations Peat peloid pack Warming socks



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Consultants

1) Health Psychology Consultant, David Dennis, ND

Consults with the Health Psychology Consultant are optional, but highly

recommended. Examples of appropriate issues on which to consult include (but are

not limited to) cases with a psychological or counseling component; cases of trauma,

abuse, or addiction; cases involving psychiatric diagnosis, developmental delay,and/or dual diagnosis, etc.

The Counseling Consult form (available on Moodle, Clinic Forms and Resources) must be

completed and brought to your appointment. The Consultant will not see you

without this completed form and the patient file.

Interns are responsible to sign up for these consults. Sign-up will be available through

the Moodle Clinic Forms and Resources page.

2) Primary Care Consultant, Dr. Michael Salsberg MD

Each student is required to complete two consults with Dr. Salsberg, MD. One

consult should focus on primary medical care questions while the second consult

should focus on the use of lab tests in the diagnosis of illness. Examples of

appropriate issues on which to consult include (but are not limited to) differential

diagnosis of symptoms, pharmaceutical side effects and interactions, conventional

treatment protocols in advanced and/or complicated disease.

The minimum total number of Primary Care consults required is 2. This is due by the end of your third semester:


Interns are responsible to sign up for these consults by the date indicated on the sign

up schedule. Students who fail to sign up by the deadline will be placed in the

remaining available spots. Sign-up procedures will be announced through the Moodle

course shell.

3) Practice Management Consultants, Nadine Cyr ND & Erin Truscott-BrockND

Each student is required to complete one consult with their assigned practice

management consultant. The Practice Management Consult form (available on

Moodle, Clinic Forms and Resources) must be completed and brought to your first

appointment. The Consultant will not be able to meet with you without this

completed form.



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The minimum total number of Practice Management consults required is 1.

This is due by the end of your second semester:


You will be scheduled for these consults by the OCE. The schedule will be posted onMoodle (Clinic Forms and Resources).

Practice Management Portfolio

4) Optional Consults Available

Traditional Asian Medicine/Acupuncture consults are available throughout the

year with Neemez Kassam, ND. Sign-up will be available through Moodle.

Physical Medicine consults are available throughout the year with Lowell Greib,

ND. Sign-up will be available through Moodle.

Case Management Forms (CMFs)

The minimum total number of CMFs required is 12.

These are divided per semester:

CLE404 (1st term) = 4 CMFs (1 per supervisor, chosen by supervisor)

CLE412 (2nd term) = 4 CMFs (1 per supervisor, chosen by supervisor) CLE450 (3rd term) = 4 CMFs (1 per supervisor, chosen by supervisor)

Case Management Forms may be completed for any new patients of CCNM

Teaching Clinics with 3 or more visits. The CMF template in the Moodle

CLE404/412/450 course shell should be used.

CMFs should be completed soon after the patient’s third visit.

Practice Management Portfolio: CLE450

In consultation with their Practice Management Consultant, Interns will build a

portfolio of practice management and marketing techniques. This is a P/F

assignment that is a requirement for CLE450. The due date for submitting the

completed Practice Management Portfolio will be announced with the Practice

Management consult schedule. Late submissions will be deducted 10% each

day past the submission date, which will reflect on P/F grading. Full details to

be posted on Moodle (Clinic Forms and Resources).



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MYMOPs (at least 3) are a requirement of each CMF.

CMFs must be submitted electronically to the Moodle CLE404/412/450

course dropboxes. Marked CMFs may be returned by the Supervisor to the intern for revision.

o An intern is allowed a maximum of 2 revisions for each CMF. If the CMF

is still not adequate after 2 revisions, it will be considered a fail and willnot be counted towards requirements.

Any paper copies must be shredded, as no patient information may legally be

kept outside of the patient file.

Once a CMF is passed, your supervisor enters a Pass into the Moodle

CLE404/412/450 course shell.

2013-14 Deadlines for submission of CASE MANAGEMENT FORMS

Summer Term:

o Upload CMFs to Moodle course shell for marking by: August 10, 2013

Fall Term:

o Upload CMFs to Moodle course shell for marking by: November 30, 2013

Winter Term:

o Upload CMFs to Moodle course shell for marking by: April 12, 2014

Please Note: These submission dates represent the last date for Case Management Forms to be

submitted for marking as revision may be necessary prior to a passing grade being granted. Latesubmissions that are not submitted by the printed deadlines will be subject to the policy governing

late course assignments: late submissions will be deducted 10% each day after the deadline to a

maximum of 35%. A failing grade will be given to any submission that is more than 3 days late, as a

grade below 65% constitutes the threshold for failure.



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CASE MANAGEMENT RUBRIC, 2013-14

SUBJECTIVE COMPLETE INC Chief concerns – clear and concise description that includes only

the most vital information. (Additional details may be discussed in

“Clinical Impression”.)

OBJECTIVE COMPLETE INC Physical exam – only the most relevant negative & positive

findings

Laboratory values or other diagnostic studies - only the most

relevant negative & positive findings

MYMOPs – must be performed before treatment is started andideally at each subsequent visit until the problem resolves.

ASSESSMENT COMPLETE INC Clinical Impression – Well-supported hypothesis as to major

contributors & root cause of the case. Should include differential

diagnoses, including rule in/rule out criteria. All differential

diagnoses are well supported by subjective and objective findings.

Includes short & long term prognoses.

Working dx –Includes clearly stated rationale. All working

diagnoses are well supported by subjective and objective findings.

ICD-10 codes for all working diagnoses.

PLAN COMPLETE INC Treatment Goals – Clear rationale for treatment plans. Treatment

goals supported by subjective and objective findings Short-term and

long-term goals concisely & clearly articulated.

Other Treatments & prescriptions from other healthcare

practitioners (including posology & duration)

Self-prescribed treatments - supplements, treatments, etc.

(including posology & duration)

Intern Treatments – In-office treatments. Clear & complete

treatment plan instructions, including posology and duration.

Follow–up plan including timing & plans for subsequent visits.

OTHER COMPLETE INC Written style is succinct and easy to follow Tone is neutral and professional

CMF submitted in a timely fashion (i.e. within a reasonable time after

the 3rd visit)

To receive a Pass, each section of the CMF must be adequately completed

based on the rubric provided below.



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EVALUATIONS

PRIMARY INTERN COMPETENCIES EVALUATION FORMS (“PICE Forms” )

Using the Primary Intern Competencies Evaluation Form or PICE Form, Interns will beevaluated throughout the term on 12 clinical competency areas. These competency

areas are:

1. Clinical/Medical Knowledge

2. Interviewing Skills

3. Physical Exam Skills

4. Diagnostic Acumen

5. Research Skills

6. Charting Technique

7.

Patient Management & Treatment Skills8. Communication & Collaboration Skills

9. Patient Rapport

10. Knowledge of Naturopathic Therapies and their Proper Application

11. Professionalism & Ethics

12. Practice Management

The PICE form allows for specific feedback to each intern on areas of strength,

weakness, and little/no activity.

MIDTERM PICE EVALUATIONInterns will receive a completed PICE form from each of their 4 Supervisors at the

midterm of the semester (see Midterm Evaluation dates listed below). This PICE form

will be your Midterm Evaluation and will represent a summary of all activity observed

by the supervisor up until the Midterm date. The intern will be given a numerical mark

to represent their level of achievement to date; this is a formative grade used only for

feedback.

A list of Clinic Advisor assignments is posted in the Moodle Clinic Forms and

Resources page. Interns are required to sign up for a mandatory Advisor meeting ineach term, to discuss the results of the midterm evaluations. Sign-up sheets will be

posted on the 4th Yr. Clinic Bulletin Board around the Midterm Evaluation dates.

Interns identified on the Midterm Evaluations as requiring improvement in specific

areas are advised to discuss strategies with both their Advisor and supervising

faculty to improve in these areas before the Final Semester Evaluations.



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The Midterm Evaluation dates for 2013-2014 are:

July 6, 2013

October 26, 2013

March 1, 2014

FINAL PICE EVALUATION

Interns will receive a second completed PICE Form from each of their 4 supervisors

during the last month of the semester. This PICE Form will be your Final Semester

Evaluation and will represent a summary of all activity observed by the supervisor

from the Midterm date until the Final Semester Evaluation date. The intern will be

given a numerical mark to represent their level of achievement to date; this is a

summative grade and will be used to determine whether an intern passes the Final

Semester Evaluation.

Please keep in mind that performance expectations increase with each subsequent

semester.

The Final Semester Evaluation dates for 2013-2014 are:

August 24, 2013

December 14, 2013

April 26, 2014



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PRIMARY INTERN COMPETENCY EVALUATIONS: FLOW CHART

MIDTERM SEMESTER EVALUATION

Supervisors fill out PICE Form (ratings scales)based on student activity from beginning of

semester until the Midterm Eval date & upload

to Moodle.See pg. 28 of Manual for due dates

FINAL SEMESTER EVALUATION

Supervisors fill out PICE Form (ratings scales)based on student activity from Midterm Eval

date to the Final Eval date & upload to Moodle.See pg. 28 of Manual for due dates

Advisors receive all 4 Supervisors’ PICE forms

for each advisee from the OAA, for discussion

during Advisor mtgs.

OAA notifies interns to sign up for mandatory

Advisor meetings on posted sign-up sheets onthe 4th Year Clinic Bulletin Board beside the

OAA.

Advisors complete “Advisor Summary” sheet foreach advisee and upload to Moodle.

Advisors are required to notify ADCE if any

students not passing at this time.

To achieve a PASS on Final Semester Evaluation: CLE404: an overall rating of “good performer”

must be achieved in 10 of 12 categories.

CLE412 an overall rating of “good performer”

must be achieved in 10 of 12 categories.

CLE450: an overall rating of “good performer”

must be achieved in ALL categories.

Interns identified on the Midterm

Evaluations as requiring improvement are

advised to discuss specific strategies with

both their Advisor and supervising faculty to

improve these areas before the Final

Semester Evaluations.

Supervisors are required to notify ADCE if

any student has not passed FinalSemester Evaluation.*See Pass criteria below.



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PRIMARY INTERN COMPETENCY EVALUATIONS INTERN: ___________SUPERVISOR:____________COURSE: ____ Mid Final ADVISOR:___________

Please circle an overall rating in each category: 1 = poor; 2 = marginal performer; 3 = good performer; 4 = strong performer; 5 = exceptional

Clinical/Medical Knowledge

1 2 3 4 5

Evidence:

Interviewing Skills

1 2 3 4 5

Evidence:

Physical Exam Skills

1 2 3 4 5

Evidence:

Diagnostic Skills

1 2 3 4 5

Evidence:

Research Skills

1 2 3 4 5

Evidence:

Charting Technique

1 2 3 4 5

Evidence:

Therapeutic Management

1 2 3 4 5

Evidence:

Communication & Collaboration

1 2 3 4 5

Evidence:

Patient Rapport

1 2 3 4 5

Evidence:

Knowledge of Naturopathic Therapies

1 2 3 4 5

Evidence:

Professionalism & Ethics

1 2 3 4 5

Evidence:

Practice Management

1 2 3 4 5

Evidence:

*To achieve a PASS on a Final Semester Evaluation:

CLE404: an overall rating of “good” must be achieved in 10 of 12 categories.

CLE412 an overall rating of “good” must be achieved in 10 of 12 categories.

CLE450: an overall rating of “good” must be achieved in ALL categories.



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PRIMARY INTERN COMPETENCIES

1. Clinical/Medical KnowledgeExamples of skills in this competency area:

A.) Demonstrates an understanding of how anatomy, biochemistry and pathophysiology relate to patient

complaints, assessment and diagnosis.

B.) Well prepared for patient visits. Able to triage acute patient presentations.

C.) Identifies interactions and potential interactions between therapies.

D.) Able to assess and apply current medical information in the care of patients.

E.) Demonstrates knowledge of the contributing factors to disease and the ways in which they

impact health.

F.) Demonstrates knowledge of indications for and interpretation of results of commonly used

diagnostics.

G.) Demonstrates knowledge of the most frequent clinical, laboratory, and pathologic manifestations of

common diseases.

H.) Demonstrates knowledge of the epidemiology of common diseases and the systematic approaches to

reduce incidence and prevalence of the disease.

I.) Identifies factors that place individuals at risk for disease or injury, select appropriate tests for

detecting patients at risk, and determine strategies for response.

2. Interviewing SkillsExamples of skills in this competency area:

A.) Obtains an accurate and thorough medical/case history in a timely manner.

B.) Integrates a patient’s verbal and written information. Recognizes concerns not clearly stated by

patient.

C.) Conducts focused inquiry for all age groups.

D.) Ascertains safety risk to self and others, as indicated.

E.) Documents all medical correspondence.

F.) Is thoroughly familiar with current and past treatment plans and outcomes.



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3. Physical Exam SkillsExamples of skills in this competency area:

A.) Performs complete health exams in a timely manner, including asking supervisor to confirm findings.

B.) Performs organ system-specific and/or hypothesis-driven examinations

C.) Medical equipment in working order. Obtains vitals on a regular basis.

D.) Able to conduct focused inquiry for all age groups.

E.) Adapts exams to individual patient circumstances and comfort.

F.) Ensures faculty supervision before performing any male or female genital or breast exams.

G.) Differentiates and accurately interprets normal and abnormal findings on physical exam.

4. Diagnostic SkillsExamples of skills in this competency area:

A) Creates reasonable differential diagnosis lists.

B) Creates plans for ruling out/in possible conditions, detailing steps necessary to arrive at working

diagnoses.

C) Recognizes patients with immediately life-threatening conditions.

D) Interprets laboratory tests, demonstrating the ability to integrate clinical and laboratory findings.

E) Able to incorporate uncertainty explicitly into clinical decision making, demonstrating the ability to

identify missing clinical information and determine when it is appropriate to act on incompleteinformation.

F.) Demonstrates the ability to use information technology to locate existing data sources.

F) Reasons deductively in solving clinical problems

5. Research SkillsExamples of skills in this competency area:

A.) Able to retrieve, manage, and utilize biomedical information for solving clinical problems and making

therapeutic decisions.

B.) Demonstrates critical assessment of the quality and validity of all information.

C.) Makes decisions based on evidence, when such is available, rather than opinion.

D.) Employs skepticism, curiosity, and humility in the face of the unknown.



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6. Charting techniqueExamples of skills in this competency area:

A.) Chart is presented in proper format, and organized properly in the file folder, according to the RSNC

charting guidelines.

B.) Consent to treatment form signed by the patient or the patient’s designated signatory prior to any treatment.

C.) Privacy Consent Form signed prior to any treatment.

D.) Chart is legible and completed in blue or black ink. Each page is dated and identified with patient name.

Accurate medical terminology in all sections of chart.

E.) Completed treatment summary for each visit, including any changes in supplements/medications and lab

results.

F.) Charting includes rationale of therapies suggested. Treatment plan reflects all suggested activities and all

ongoing treatment.

7. Therapeutic managementExamples of skills in this competency area:

A.) Understands the implications of the patient’s illness.

B.) Plans for appropriate follow-up, including referrals, diagnostic testing, bloodwork, etc.

C.) Constructs appropriate management strategies for patients with common conditions.

D.) Formulates treatment plans that reflect the relative certainties of the differential diagnosis.

E.) Monitors patient progress and appropriately modifies treatment plan to improve treatment outcomes.

F.) Formulates treatment plans that reflect the relative risks/benefits of treatment options and outcomes.

G.) Educates healthy patients about prevention of future illness (primary prevention).

H.) Educates patients with common illnesses about prevention of further illness (secondary prevention)

I.) Educates patients about their use of common naturopathic therapies and expected side effects.



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8. Communication and Collaboration Examples of skills in this competency area:

A.) Contributes actively to shift preview and review.

B.) Works effectively as an individual, in inter-professional groups, and as a member of the health care system.

C.) Able to orally summarize a patient’s case in a complete, coherent and concise manner.

D.) Completes referral letters, release of record forms and other necessary paperwork, in a timely fashion.

E.) Able to employ effective oral & written communication with patients, patients’ families, colleagues, and

others with whom the intern must exchange information.

9. Patient rapport Examples of skills in this competency area:

A.) Demonstrates active listening in interviewing the patient.

B.) Demonstrates empathy with the patient.

C.) Is present and conscientious in patient care.

D.) Addresses all stated concerns of the patient.

10. Knowledge of Naturopathic Therapies & their ApplicationExamples of skills in this competency area:

A.) Provides well-researched rationale for patient’s therapeutic plan.

B.) Creates therapeutic plans that take into consideration the patient’s circumstance and ability to implementthe plan.

C.) Able to prepare treatment plans in acute situations within the given time constraints.

D.) Demonstrates knowledge of the safe and effective dosage ranges of naturopathic remedies.

E.) Able to discuss how the naturopathic principles are integrated into the individual patient’s treatment plan.

F.) Demonstrates the technical ability to apply modalities.

G.) Communicates accurate prognosis based on therapeutic intervention.



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11. Professionalism and Ethics Examples of skills in this competency area:

A.) Arrives at preview and review on time. Starts and ends patient visits on time.

B.) Communicates with all clinic staff, faculty and colleagues in a courteous and respectful manner.

C.) Does not make treatment suggestions to the patient without the prior approval of the supervisor.

D.) Shows compassionate treatment of patients, and respect for their privacy and dignity.

E.) Respects patient confidentiality, demonstrating knowledge of the legal, ethical, and medical issues

surrounding patient documentation, including confidentiality and data security.

F.) Demonstrates respect for cultural and socioeconomic diversity.

G.) Recognizes and accepts limitations in their own knowledge and clinical skills, and demonstrates a

commitment to continuously improve their knowledge and ability.

H.) Meets the professional standards of the BDDT-N.

12. Practice Management Examples of skills in this competency area:

1. Exhibit strong planning and time management skills.

Starts and ends scheduled appointment on time.

Prepares for and has clear agenda for each patient visit.

Adapts visit agenda, ensuring visit does not end abruptly.

Meets requirements’ timelines (i.e. CMF’s, PICE’s)

2. Communicate with patients short and long-term plans, projected timelines, and follow-up

expectations. Schedule the follow-up(s) accordingly

Create reasonable time-lines for management of chronic disease patients.

Closes every appointment by confirming timing of subsequent appointment(s) and patient

understanding of prescriptions.

3. Actively support long-term case management.

4. Utilizes a variety of techniques for increasing patient base, including but not limited to public

presentations, community and/or corporate health fairs, social networking, etc.



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EXTERNSHIP PROGRAM

Externship refers to an intern conducting a portion of their clinical education at a

site external to RSNC. The Intern is expected to engage in clinical patient interactions

in a similar manner as they would at RSNC, under the supervision of the licensed

naturopath who oversees that external clinic. Interns are expected to be given a high

level of autonomy with the Supervising ND providing guidance. The Externship may

not exceed 20% of the intern’s total graduation requirements in regards to modalities,

physical examinations and patient visits, and 10% of the intern’s total requirements in

regards to hours. This program is an optional component of the naturopathic

medicine program, and each application is subject to the approval of the Associate

Dean, Clinical Education and/or Dean.

For the 2013-14 academic year the Externship Program is offering 3 month-long

options and 3 weekly options:

Month long Externship options:

August 2013 month long externship

November 2013 month long externship

February 2014 month long externship

One day per week Externship options:

September - December 2013 weekly externship

January - April 2014 weekly externship

May - Aug 2014 weekly externship (only for students in CLE450 during

that time)

Applications are assessed based on the quality of the Externship site, and the host’s

ability to fulfill obligatory supervisory criteria.

DEADLINES FOR A PPLICATION

Externship forms may be submitted to the Office of Clinical Education for approval by

the following deadlines:

August Month Externship : June 15, 2013 September - December Weekly Externship : June 15, 2013

November Month Externship September 15, 2013

January - April Weekly Externship : November 15, 2013

February Month Externship : November 15, 2013



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May - August Weekly Externship : March 15, 2014

For further information, please refer to the Externship Program Package 2013-2014,

available on Moodle (Student Resources> Forms & Resources>Clinic).

CLE100, CLE201 and CLE310

You will encounter students from all other years shadowing supervisors and

observing with 4th Yr. interns at the RSNC and satellite clinics. Here is a summary of

their activity and your involvement with first, second & third year students:

CLE100:

First year students shadow supervisors on Saturdays only, during the fall and

winter semesters.

First year students do not shadow 4th yr. interns.

o 4th yr. interns have no activities or requirements associated with

CLE100.

CLE201:

Second year students shadow supervisors from 2-8pm on Thursdays and

Fridays during the fall semester only.

Second year students also shadow 4th yr. interns from 4-8pm on Wednesdays,

Thursdays and Fridays during the fall semester only.

o 4th yr. interns with shifts on Wed, Thurs and/or Friday 2-8pm will be

shadowed by 2 nd yr. students, and will provide these students with

critical feedback on 15 minute physical exam and intake activities.

o If you have shifts Wed, Thurs and/or Friday 2-8pm, you may have a 2 nd

yr. student with you on more than one of your shifts. However, you are

never required to have more than one observer sit in during any patient

visit.

CLE310:

Third year students do not shadow supervisors.

Third year students are paired with 4th yr. interns and function as secondary

interns from 2-8pm on Tuesdays, Wednesdays, Thursdays and Fridays, as well

as 8-2pm and 10-4pm on Saturdays during the winter semester only.

o 4th yr. interns with shifts at these times will be paired with a 3 rd yr.

student who will participate in decision making and provision of

treatment for patients.



CLE310IMG:

The International Medical Graduate program at CCNM will allow these students to

observe and participate in the clinical setting through a series of graduated

observations and interactions. Students will follow a similar schedule and activity

requirement as is programmed throughout the Clinical Education Courses, CLE100,CLE201 and CLE310.

MONTHLY RECORD KEEPING

The following original documents should be included with the Monthly Summary:

Monthly Summary Cover Page

Monthly Open Work Order Attendance Sheet with all supervisor signatures

Secondary Clinical Contacts Record with all supervisor signatures

Timesheet for Preceptorship Hours

Seminar Hours (only applies to students who entered CCNM before

Sept. 2008)

All documents are available on Moodle (Clinic Forms and Resources). Interns are

advised to keep copies of all submitted paperwork. Originals are kept in your

student file in the OCE.

POLICY ON CONVOCATION

CCNM recognizes that Interns may want to participate in the graduation ceremonies

even if they have not have achieved all clinical requirements necessary to graduate.

At the discretion of the Dean, Interns may be permitted to participate in graduation

ceremonies provided they have achieved 65% of their total clinical requirements by

May of that year. The Dean must be satisfied that the Intern is making satisfactoryprogress in achieving clinical competency and will complete all requirements before

August 31 of that year. A diploma will not be granted until the Intern meets all

requirements necessary for graduation.

Primary Intern Manual

Documents

Transcript of Primary Intern Manual