Fillable Form 1: EXTRAMURAL CLERKSHIP: POLICIES AND APPLICATION FOR (Tulane University)

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Form 1: EXTRAMURAL CLERKSHIP: POLICIES AND APPLICATION FOR (Tulane University)

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EXTRAMURAL CLERKSHIP: POLICIES AND APPLICATION FOR APPROVAL
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EXTRAMURAL CLERKSHIP: POLICIES AND APPLICATION FOR APPROVAL
Tulane has designed its extramural clerkship (“away rotation”) approval process to meet LCME standards for
oversight of extramural electives.
1
Students must have departmental approval for an away rotation and must upload required documents at least
30 days before the away rotation is scheduled to begin. Credit will not be given for away rotations that have
not been approved at least 30 days in advance. No retroactive schedule changes will be made.
Domestic away rotations can be completed only at ACGME- or LCME-accredited institutions or programs.
• LCME directory: http://lcme.org/directory/
• ACGME directory: https://apps.acgme.org/ads/public/
International away rotations must be approved through the Department of Family and Community Medicine.
Students pursuing international rotations must complete this form and additional steps to ensure your safety
and the quality of your educational experience. See the department for more information.
Step 1: Departmental Approval
Away rotations require approval by the faculty of the Tulane department equivalent to the away rotation
department. For example, Tulane’s Surgery Department must approve a surgery away rotation. You may begin
this process before you are accepted to the rotation.
1. Complete all information on the attached extramural clerkship approval form
2. Attach a description of the rotation
3. Submit the form and description to the clerkship faculty director of the appropriate Tulane department. For
departments without clerkship directors (such as dermatology, orthopedics, urology, etc.), the chair or the
chair’s faculty designee must approve the away rotation request. Only faculty may approve away rotations.
To meet LCME accreditation standards and to ensure a productive and safe learning environment, students and
faculty should discuss the following, particularly for international electives and electives in non-traditional
environments:
• Potential risks to the health and safety of patients, students, and the community
• The availability of emergency care
• The possibility of natural disasters, political instability, and exposure to disease
• The need for additional preparation prior to, support during, and follow-up after the elective
• The level and quality of supervision
• Any potential challenges to the code of medical ethics adopted by the home school
Step 2: eMedley Documentation
Students must upload all of the following as a single document into the “documents” tab in eKeeper in eMedley
(see next page for guide to uploading in eKeeper):
1. Extramural clerkship clerkship form approved by a faculty member of the appropriate Tulane department.
2. Description of the rotation.
3. Acceptance letter, email, or screenshot from the host institution that identifies the student’s name, rotation
name, and rotation dates.
This process can be completed only after you have been accepted by the host institution.
1
Standard 11.3, “Standards For Accreditation of Medical Education Programs Leading to the MD Degree,” published March
2016.
EXTRAMURAL CLERKSHIP: POLICIES AND APPLICATION FOR APPROVAL
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To upload your document in eMedley:
Save the approved form, description, and acceptance as a single document. Then
(A) Log in. From eKeeper, select “My Dashboard”:
(B) Select “Documents” tab:
(C) Select “Add Document”:
(D) Select “Away Approval Form” from the “Type”
field:
(E) Use the “Browse” button to select your SINGLE
DOCUMENT that includes approved form and
rotation description. Select “open” to upload.
(F) Select “Insert”
(G) Your form will now appear in “Documents”:
(H) Email SOMSchedule@tulane.edu that your
documentation has been uploaded
EXTRAMURAL CLERKSHIP: POLICIES AND APPLICATION FOR APPROVAL
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Step 3: Committee Decision
Email SOMSchedule@tulane.edu to indicate that you have uploaded a completed, approved away rotation
application (and supporting documentation) to your eKeeper. Await review and approval by the approval
committee that includes Student Affairs and Academic Affairs administrators.
You will receive an email either that the rotation has been added to your schedule, has been declined, or requires
more documentation. As always, check your email daily.
Step 4: Host Institution Paperwork
You may need to provide your host institution with various kinds of documentation. See the PDF “Where do I
get away rotation documents” for information about how to request transcripts, health-related documents,
insurance proof or certificates, etc.
Step 5: Rotation Changes and Follow-up
If you will not complete an away rotation that has been approved, you must email SOMSchedule@tulane.edu
more than one week before the rotation is scheduled to begin to request that the rotation be dropped. If you
do not meet this deadline, you will earn an F in the scheduled rotation.
After you complete an away rotation, the following documents must be submitted before you will be assigned a
final grade. It is your responsibility to follow up on both documents.
• Your supervisor’s evaluation of your performance.
https://tmedweb.tulane.edu/portal/files/open-
access/Clerkships/EVAL_6-6-13.pdf
• Your evaluation of the away rotation. You will be asked to complete an evaluation of your away rotation
through E-Value, just as you are asked to complete evaluations of Tulane rotations. Completing evaluations
is a component of professionalism and provides students with valuable information about the quality of
your experience at a particular program.
A special note on away sub-internships:
Students may complete sub-internships in the following fields:
• Family medicine
• Medicine
• Neurology
• OB/Gyn
• Pediatrics
• Psychiatry
• Surgery
• Urology
Tulane students may complete away sub-internships in all of the fields listed above, plus orthopaedics.
Some Tulane departments do not offer team-based, inpatient medical care (for example, emergency medicine,
dermatology, pathology, radiation, radiation/oncology) and do not, therefore, offer sub-internships.
If you wish to complete an away sub-internship, you must follow these additional guidelines:
• The school offering the away rotation must explicitly title the rotation a sub-internship. (One method is to
search in VSAS for “sub-internships.”)
• The sub-internship must be in a specialty Tulane deems eligible. For example, some sites offer emergency
medicine, dermatology, radiation, etc. sub-internships; however, because these specialties do not meet
Tulane’s standards for a sub-internship, these rotations will not fulfill your Tulane sub-internship
requirement. You may still opt to complete them as an away elective.
• You must have your away rotation specifically approved as a sub-internship. A field on the form allows you
to indicate that you are requesting sub-internship credit for the away rotation.
EXTRAMURAL CLERKSHIP: POLICIES AND APPLICATION FOR APPROVAL
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Students complete this portion:
Student information
Rotation information
Date of form:
Dates of rotation:
Name of rotation:
Tulane’s equivalent
department:
Are you requesting
sub-internship credit
for this rotation?
Have you read and understood Steps 1 – 5 in the
“EXTRAMURAL CLERKSHIP: Policies and Application
for Approval” above?
Yes
No
If no, you are not eligible to complete an away rotation.
Have you completed all of your “donut” rotations?
Yes
No
If no, you are not eligible to complete an away rotation.
Is the host program ACGME- or LCME accredited?
Yes
No
If no, you cannot receive credit for this rotation.
Institution information
Away rotation contact person
Name of institution:
Full name of contact:
Street address of
institution:
Contact title:
City and state of
institution:
Contact email:
Zip code of institution:
Contact phone number:
ACGME code OR initial
year of LCME
accreditation (see
directory links in
instructions above)
Tulane departmental faculty complete this portion:
Clerkship faculty directors, departmental chairs, or the chair’s faculty designee may approve away rotations.
I have reviewed the elective description and approve it for elective credit.
Signature of approver:
Printed name of approver:
Title of approver:
Date of approval:
ASA
USE
Date received:
Course:
Committee review:
CRN:
MK:
KK:
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Completed 22 February 2022

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