Jul 21, 2024  
2022-2023 Academic Bulletin (July 2022 Ed) 
2022-2023 Academic Bulletin (July 2022 Ed) [ARCHIVED CATALOG]

Policies and Procedures for Clerkships and Electives

Counseling for Clerkships and Electives

Departments have designated contact faculty for their educational programs. These faculty members, generally the clerkship director, should be a student’s first point of contact in matters of specific departmental concern in the curriculum. In addition, administrative details can be handled by the designated contact person. For more information, see: http://www.uthsc.edu/Medicine/medicaleducation/clerkships/.

Clerkship Locations

All required rotations must be taken at an institution within the University of Tennessee System. There may be extenuating circumstances exempting selected students from this policy. A student who wishes to be granted an exemption must present his/her case to the Assistant Dean for Clinical Curriculum for review.

Selected clerkships and electives may be taken in the College of Medicine at Memphis, Knoxville, Chattanooga, Nashville, or Jackson. The sites at Knoxville, Chattanooga, and Nashville offer a variety of clerkships, as well as clinical and basic science electives. Senior programs are available at all five sites (although not in each discipline). Not all electives are offered on a continuing basis. Students should refer to the individual elective description for additional information.

Option Periods (OPN 45000)

Students in the College of Medicine have twenty (20) option weeks (5 option blocks) usually taken in the fourth year. Students must use 2 option blocks (8-weeks) during the months of November, December or January to interview for residencies and other personal business. Jobs and/or non-credit work can be arranged during option weeks with faculty members. Any student interested in applying for a research award during option weeks should contact the office of the Vice Chancellor for Research for additional information.

Electives at Other Institutions

A maximum of twelve weeks of electives may be taken by students at other institutions. Any student applying for an elective at another institution must be in good standing in the College of Medicine, have satisfactorily completed the core clerkships of the third year, and have permission from the appropriate clinical department chair as well as the Assistant Dean for Clinical Curriculum. Electives at other institutions are normally taken for credit and, thus, tuition is paid at the University of Tennessee. The cooperating institution must be affiliated with an accredited medical school, must agree to accept and evaluate the student, and must certify that the elective being applied for is a regularly offered medical student elective at that institution.  Electives taken outside of the state of Tennessee will be bound by state authorization regulations as determined by the state in which the elective is to occur (unless the elective occurs at a federal facility such as a VA Medical Center or if the elective is arranged through the Visiting Student Application Service - see below). For more information students should contact the Associate Dean for Student Affairs.

An “Elective Away Application” form is available electronically at http://www.uthsc.edu/Medicine/medicaleducation/students/forms.php or in the Office of Medical Education. This form must be completed and on file in the Office of Medical Education before the elective begins in order for formal academic credit to be awarded.

Dropping/Adding Rotations

All rotations (i.e., the required clerkships, selectives, and electives) may be dropped/added if the process is at least thirty days prior to the beginning of the Block. Routine changes are affected by accessing the web-based program for scheduling the rotations. The web-based clerkship scheduler can be accessed at https://he.emedley.com/uthsccom.

Student Workload - Clinical Clerkships

The educational experiences in the clinical clerkships of the UTHSC College of Medicine are presented in various formats, which include: patient experiences in a hospital or physician’s office, procedural workshops, skills laboratories, reading assignments, tutorials and didactic lectures. These clerkships provide a breadth of clinical experiences whereby students, under supervision by residents and faculty as well as other health professionals in the teaching hospitals, assist in the care of patients in order to master clinical knowledge, skills and attitudes. In these clinical experiences, students observe the patient, the illness, the effects of procedures and treatment over an adequate span of time in order to learn the natural history of the diseases and the specific effects of interventions to include treatment and/or prevention. This often is best done by being present and working with the patient over a relatively long period of time as the expression of the illness unfolds. Accomplishing this requires that students be assigned continuous patient care and in-house call for prolonged periods on some specific rotations. To address the time commitment required of medical students during clinical rotations, and taking into account the effects of fatigue and sleep deprivation on learning, clinical activities, student health and safety, and patient safety, the medical school has adopted the following policy.

  • Duty hours must be limited to 80 hours per week averaged over a four-week period, inclusive of all in-house call and patient care activities.
  • Continuous on-site duty, including in-house call, must not exceed 30 consecutive hours.
  • Students may remain on duty additional hours to participate in transferring care of patients, conducting outpatient clinics, maintaining continuity of medical and surgical care, and attending required didactic activities.
  • Students must be provided with one day in seven free from all educational and clinical responsibilities, averaged over a rotation, inclusive of call. One day is defined as one continuous 24-hour period free from all clinical, didactic, and administrative activities.
  • Students should be provided with a 10-hour period after in-house call during which they are free from all patient care activities.
  • Students are responsible for entering their work hours into the web-based work hour’s log, which is accessed through the Student Information System web page.

The director for each clerkship will be responsible for scheduling student work hours, monitoring the intensity of each rotation, assuring that undue stress and fatigue among students is avoided, and arranging adequate resident and faculty supervision. This supervision by the attending faculty member ensures that students are assigned only patient care responsibilities for which they are qualified and that students are required only to perform functions appropriate to their educational program. The clerkship director also will be responsible for ensuring that the students’ acquisition of knowledge, skills and attitude necessary to progress are documented. The Assistant Dean for Clinical Curriculum will be responsible for reviewing each clerkship’s compliance with this policy on a periodic basis. Students may appeal the workload in a particular clerkship if they feel that it is inappropriate. The appeal is directed initially to the clerkship director and then to the department chair. If resolution of the issue is not made at the department level then the concerns of the students should be presented in writing to the Assistant Dean for Clinical Curriculum.

Students are not permitted to take vacation time during their required clerkship experiences. While the college recognizes that important networking may occur at academic conferences, students may be excused to attend an academic conference only if they have been invited to present their scholarly work.  As these invitations occur well in advance of the conference, students should notify the clerkship director before the start of their rotation by completing the Limited Leave Request form (https://www.uthsc.edu/Medicine/OLSEN/documents/limited-leave-request-form.pdf) and reviewing the Excused Absence and Wellness Day policy COM106 (https://uthsc.policymedical.net/policymed/).  Students are encouraged to pursue important opportunities for networking during non-clerkship times.  Students should be judicious in their requests and time away from their required clinical training should be minimized.

Excused Absences

In the spirit of professional behavior and the mastery of educational objectives, students are expected to be at all educational activities. In the clinical years, students are required to be present at all times set forth by the clinical faculty member. However, there are a variety of reasons for a student to be absent from a required activity.  These may include:


  • Students may be excused for the death of immediate family only.  It will be up to the Clerkship Director as to what “immediate” means, how much time will be given off, how much needs to be made up and when.

Medical appointments

  • Requests for time off for medical appointments should be approved by the Clerkship Director as soon as possible or at least 30 days before the start of the rotation. When possible, students are encouraged to schedule medical appointments at times that do not conflict with educational or clinical obligations.


  • Students may be excused for the weddings of immediate family members or close friends. Students should submit a request using the Limited Leave Request form (https://www.uthsc.edu/Medicine/OLSEN/documents/limited-leave-request-form.pdf) for permission to be absent no less than 30 days before the start of the course or clerkship.

Step 2 CK/CS

  • Students must complete all CORE M3 clerkships before taking the Step II CK. On a case by case basis, exceptions may be made by the Assistant Dean for Clinical Education.

  • Students may not take time out of required M4 rotations/JIs to take Step II CK/CS. 

  • Students must submit a request in writing for permission to be absent from an elective at least 30 days prior to the beginning of the rotation.

  • Permission must be obtained from the Clerkship Director and faculty member in charge of the elective to be absent.

Residency Interviews

  • Students may not be excused for traveling for interviews in required CORE rotations/JIs.

  • Students must submit a request in writing for permission to be absent from an elective at least 30 days prior to the beginning of the rotation.

  • Permission must be obtained from the Clerkship Director and faculty member in charge of the elective.

Note:    Absences are not allowed on the first or last day of a clerkship, course or module.

Visiting Students Application Service

The Visiting Student Learning Opportunities (VSLO), formerly know as the Visiting Student Application Service (VSAS), is an AAMC application designed to streamline the application process for senior “away” electives at other U.S. LCME medical schools. This service requires students to submit just one application for all schools, effectively reducing paperwork, miscommunication, and time. VSAS also provides a centralized location for managing offers and tracking decisions. It was created at the request of two GSA committees: Committee on Student Records (COSR) and Committee on Student Affairs (COSA). https://students-residents.aamc.org/attending-medical-school/article/visiting-student-learning-opportunities/.

Guidelines for Visiting Medical Students

UTHSC College of Medicine has elective opportunities available at its sites in Memphis, Knoxville, Chattanooga, Nashville and Jackson for medical students from other medical schools. To be eligible for consideration, students must meet the following criteria:

  • Visiting students must be a candidate for the M.D. or D.O. degree in good standing in their final year of training in an accredited US school or from institutions with which UTHSC has a formal exchange program.
  • Visiting students shall be limited to a maximum of (12 weeks) of experiences at all UT medical campuses during their medical school career. Electives will be assigned to visiting students only after all UTHSC students have been scheduled.
  • All visiting students must have:
    • coverage for malpractice/liability insurance in the amount of $1 million per incident and $3 million aggregate from their institution or from acceptable other sources;
    • health insurance;
    • required immunizations for measles and rubella, influenza, and hepatitis B;
    • taken a TB skin test within the past year;
    • been certified in CPR within the past year;
    • a recent background check;
    • completed HIPAA training;
    • passed USMLE Step 1 or COMLEX Part 1
  • Visiting students must have completed instruction in the basic physical examination and have a working knowledge of general ward procedures. All electives require that the student has the basic Family Medicine, Medicine, Neurology, Pediatrics, Surgery, Psychiatry, and Obstetrics- Gynecology Clerkships. All students must have met the prerequisites of the clerkship to which they are applying. Any exceptions to this policy must be approved by the Associate Dean for Medical Education, campus Associate Dean or their designee at the recommendation of the Department Chair or their designee.
  • Visiting students who attend an LCME approved school must apply in VSLO  (Visiting Student Learning Opportunities) https://students-residents.aamc.org/attending-medical-school/article/visiting-student-learning-opportunities/.

Interested students can apply in VSLO no earlier than May of the junior year and at least four weeks prior to beginning the rotation. Others should request applications from the College of Medicine Office of Medical Education. All completed applications should be submitted first to the respective Departmental Office at UT before being sent to the Office of Medical Education.

It is expected that clerkship work completed at The University of Tennessee will be part of the graduation requirements of the visiting student’s program. For this reason, an authorization for taking an elective is required from the visiting student’s Dean’s Office. Section II of the “visiting student” application provides for this authorization. The visiting student must be in good standing in his/her final year and authorized to take an elective. Currently, students who are regularly enrolled in another medical school and paying tuition at that school are not charged tuition at The University of Tennessee for brief elective periods. This policy may change in the future, and the school reserves the right to charge tuition at any time.

It is the individual student’s responsibility to secure housing. Specifics about housing can be obtained from the department in which the elective rotation will be taken. Criminal background checks may be a requirement for training at some affiliated clinical sites. Based on the results of these checks, an affiliated clinical site may determine not to allow your presence at their facility.