Year 3 and 4 Policies and Procedures

RELEVANT LCME STANDARDS:      

10.9: Student Assignment

5.10: Transfer/Visiting Students

PURPOSE AND SCOPE:

To outline responsibility for and the process of assignment of students to learning experiences and responding to requests for change.

POLICY:

Clerkship and Clerkship Site Assignments

1. Clerkship and Clerkship Site Assignments are made through the Year 3 and Year 4 Lottery processes are organized and overseen by the Registrar.
2. Students rank their selections in the order in which they prefer to take the clerkships, and by the site they prefer, in Year 3 and Year 4.
3. Students have the opportunity to do one-to-one switches with other students 10 days after the lottery.
4. Final assignments for the training site are made by the Office of the Registrar, who references the number of allowed students per site, as provided by the clerkship directors.
5. Students who require a schedule to accommodate a major life event must fill out a Special Schedule Request Form during the lottery process, which allows them to determine the order of their schedule based on their needs. Requests are sent to the Office of Student Affairs who reviews and approves the request.  The Office of the  Registrar lets the student know of the decision and provides any special instructions for the lottery process.

Clerkship and Clerkship Site Changes

1. Students are notified about the Clinical Clerkship Change process during the Year 3 and 4 Lottery meetings and during each clerkship orientation.
2. Changes are allowed, on a first-come first-serve basis, up to 4 weeks before the start date, if there in room in the clerkship
3. Availability is determined by the clerkship director(s).
4. The Clinical Clerkship Change Form (signed by the Clerkship Director(s) when approved) must be submitted to the Office of the Registrar no less than  4 weeks prior to the start of the clerkship.
5. Failure to abide by this deadline can result in the change request not being processed and delay EMR access.
6. The criteria considered in evaluating the requests are availability within each clerkship and clinical site. These criteria are reviewed and approved by the clerkship director, registrar, and compliance team.  Once approved, the student’s schedule is updated in the Student Information System.
7. CLERKSHIP SITE COMPLIANCE REQUIREMENTS: If a student is switching to a clerkship that is scheduled at MS Beth Israel, MS Brooklyn, MS orningside, MS West, BronxCare, the Bronx VA, or Elmhurst, students are responsible for ensuring they have met the compliance requirements of that site.

Visiting Students

1. ISMMS students get priority in enrolling in electives across the health system prior to visiting student enrollment in these electives. Electives are not available for scheduling for visiting students until both ISMMS Year 3 and 4 students have been allowed a chance to register.
2. ISMMS students are given priority over visiting students should there be an unexpected change in schedules during electives.

PROCEDURE:

1. Students are introduced by the Office of the Registrar to the 3rd year lottery process in February of Year 2 and to the 4th year lottery in January of Year 3. 
2. Students rank their selections by the order in which they prefer to take the clerkships in 3^rd year, and the site they prefer. Students have one week to complete their preferences before the Office fo the Registrar runs the lottery and fills in the maximum spaces allowed by each site for each rotation.
3. Students who wish to request a Special Schedule Request must submit the Special Schedule Request Form by the due date during the Year 3 or Year 4 Lottery in order for it to be considered.
4. Students have a 10 day one-to-one switch period, in which they can work with another student to switch schedules or clinical sites to allow ease of switching without the knowledge of the clerkship directors. The one-to-one switches are managed through the Office of the Registrar.
5. Once the 10 day one-to-one switch period is over, the Office of the Registrar publishes the final schedule (in March of Year 2).
6. Students are notified about the Clinical Clerkship Change process during the Year 3 and 4 Lottery meetings and during each clerkship orientation.
7. Any changes subsequent to this must go through the Clinical Clerkship Change Form process, as described above.

ACCOUNTABLE DEAN OR DIRECTOR: Senior Associate Dean for Student Affairs and Senior Associate Dean for Curricular Affairs

DATE APPROVED:  May 17, 2019

RELEVANT LCME STANDARDS:      

9.1 Preparation of Resident and Non-Faculty Instructors

9.3 Clinical Supervision of Medical Students

PURPOSE AND SCOPE: 

This policy applies to individuals who supervise medical students across all courses and clerkships at all training sites. The purpose of this policy is to ensure that the school adheres to expectations that protect patients and ensure student safety, and to describe the mandatory training, teaching, and assessment skills required to be a medical student supervisor. 

Appropriate supervision ensures that medical students are provided with opportunities to learn that are progressive and commensurate with the student’s level of training and in accordance with the supervisor’s level of training and specialization.

Supervisors in the Clinical Setting

A supervisor has the capacity to allow a learner to receive progressive responsibility for patient care. Examples of possible supervisors include:

• Attending Physician of The Mount Sinai Health System and/or its affiliate training sites
• Teaching Physician in the outpatient environment of The Mount Sinai Health System and/or its affiliate training sites
• Resident Physician, Intern, or Fellow in a Graduate Medical Education (GME) program of The Mount Sinai Health System and /or its affiliate training sites
• Allied health professionals, such as Nurses, Physician Assistants, Nurse Practitioners, Social Workers, etc. of The Mount Sinai Health System and/or its affiliate training sites

Levels of Supervision – Direct vs. Indirect

1. Perform Under Direct Supervision - The student performs a task with the supervisor physically present in the same location as the student; able to provide direct instruction/feedback to the student; able to take over patient care duties if and when necessary
2. Perform Under Indirect, but Immediately Available Supervision - The supervisor may not be physically present with the student; however, they are on-duty, immediately available, and can be called to the physical location of the student if and when necessary

The limitations for the requirements of proximity and timing of supervision, as well as the specific tasks that a student may perform without direct supervision depends on various factors, including:

• the level of training (i.e. year in medical school);
• the skill and experience of the student within the scope of the clinical care situation;
• the familiarity of the supervisor with the student’s skills; 
• the acuity of the situation and the degree of risk to the patient.

Clinical Supervision – General Guidelines 

• In the clinical setting (in-patient or out-patient), Year 1 and 2 medical students are under both direct and indirect supervision and are engaged in low acuity situations (for example, conducting a history on a patient), while medical students in Years 3 and 4 are primarily under indirect supervision. It should be noted that in any instance, the supervisor should always be available. 

• The course/clerkship/site director will determine who can supervise the medical student, such as fellows, residents, and/or appropriately credentialed allied healthcare providers. 

• All medical students, during the course of their educational curriculum, may conduct medical interviews and perform physical examinations on patients with their consent.

• The supervisor will review all of the medical student’s documentation in a patient’s medical record and provide correction to the record and feedback to the student for educational purposes. 

• Clinical decisions and orders are never formulated or enacted by medical students without a supervisor’s input. Student documentation of the components of evaluation and management within a patient’s record must be verified by the supervisor before they are considered a part of the patient’s record. 

The above guidelines are applicable to all clinical experiences where medical students participate.

Procedure Supervision - General Guidelines  

• Medical students may be assigned to provide patient care services for medical procedures, under direct supervision.

• It is required that a medical student be appropriately directly supervised during all clinical procedures in which they are involved; including, but not limited to bedside, emergency department, and/or operating room procedures.  

• The degree of supervision needed will take into account: the complexity of the procedure, the stability of the patient, potential for adverse effects, and the demonstrated competence, and responsibility of each student in order to ensure the safety and comfort of the patient and the student.
• In all cases, the supervisor must have privilege or authorization to perform the procedure in which they are supervising.

How ISMMS Monitors Supervision

Any students with concerns about the adequacy and availability of supervision they are receiving are encouraged to address their concerns as soon as possible.   

Students report on the adequacy and availability of supervision during mid-clerkship check-in meetings and via end of course/clerkship evaluations and questionnaires. Students are instructed to contact their Site and/or Course or Clerkship Director regarding any immediate concerns with supervision. Additionally, reports can be made to the Medical Student Confidential Compliance Hotline, as well as to the UME Clinical Coordinator for Clinical Sites, within the Department of Medical Education.

Course and Clerkship Directors review student feedback in evaluations, as well as during mid-clerkship feedback, and provide prompt follow-up to address any supervision concerns that may arise.

 The Clinical Curriculum Subcommittee reviews data on an ongoing basis to identify any ongoing trends of supervision concerns being reported.

PROCEDURE: 

1. Students report on the adequacy and availability of supervision during mid-clerkship check-in meetings and via end of course/clerkship evaluations and questionnaires. Students are instructed to contact their Site and/or Course or Clerkship Director regarding any immediate concerns with supervision. Additionally, reports can be made to the Medical Student Confidential Compliance Hotline, as well as to the UME Clinical Coordinator for Clinical Sites, within the Department of Medical Education.
2. Course and Clerkship Directors review student feedback in evaluations, as well as during mid-clerkship feedback, and provide prompt follow-up to address any supervision concerns that may arise.
3. The Clinical Curriculum Subcommittee reviews data on an ongoing basis to identify any ongoing trends of supervision concerns being reported.

ACCOUNTABLE DEAN OR DIRECTOR: Co-Directors of the Curriculum and Senior Associate Dean for Curricular Affairs

DATE APPROVED:August 7, 2020

RELEVANT LCME STANDARDS: 

8.8 Monitoring Student Time

PURPOSE AND SCOPE: 

ISMMS is committed to and responsible for promoting patient safety and student well-being and to providing a supportive educational environment. This policy is to clarify the requirements and protection to medical students regarding the hours they are required to work during their clinical and elective rotations.

POLICY:

1. If a student is required to be on overnight call, following regular duty hours/shifts, then the student is required to be off duty by 9:00 am the next morning.
2. If no overnight call is required on the clerkship, then the extended day ends at 9:00 pm and the student is expected to return the next morning (no earlier than 5:00 am on any service)
3. In hospital on-call frequency: no more than every third night 
4. Minimum time off between duty hours: must have eight hours off between shifts including after a 24-hour shift.
5. Students are expected to attend to clerkship duties on the day before their Assessment Day. Clerkship duties should end no later than 5:00 pm on that day.
6. During Year 3, students are given one half day of protected Flex Time for every four weeks of curriculum. During Year 4, students are given one full week of protected Flex Time after Match Week.

PROCEDURE:

1. Clerkship Directors disseminate the work hours policy to clerkship faculty and house staff at Mount Sinai and affiliates. 
2. Residents, Faculty and non-educators receive the policy in advance
3. The Office of Curriculum Support disseminates the work hours policy to Clerkship Directors and Site Directors on an annual basis.
4. The policy is also presented to students prior to the start of Year 3 in InFocus 5 and during each module’s Orientation slides.
5. Anonymous clerkship evaluations allow students to share their experiences related to work hours and to report any violations. 
6. These course evaluation data are reviewed quarterly by the Curriculum and Policy Subcommittee, and Clinical Curriculum Subcommittee.
7. Yearly report outs on work hours are made to the Executive Oversight Committee. 

ACCOUNTABLE DEAN OR DIRECTOR: Senior Associate Dean for Curricular Affairs

DATE APPROVED: May 2019

Students must attain competency in certain required procedures prior to completion of medical school. The attainment of proficiency in skills is crucial to a student’s ability to function as a successful intern. Students must be provided direct supervision of procedures until proficiency can be demonstrated. There are certain procedures that students cannot do without direct supervision.

There are two (2) categories of procedures:

1. Required Core Procedures: “Required Procedures” are those for which all students must achieve competency in order to graduate. Students must do each procedure three times under direct supervision and log each time in the web-supported tracking system (One45). 
2. Suggested Procedures: “Suggested Procedures” are those procedures for which we recommend that students attain proficiency, but are not required for graduation.

RELEVANT LCME STANDARDS:      

9.7: Formative Assessment and Feedback
8.6: Completion of Core Experiences

PURPOSE AND SCOPE:

Completion of the Required Clinical Experiences for a clerkship is a joint obligation between the student, the student’s clinical supervisors, and the clerkship/site director. In order to ensure that students have adequate exposure to a variety of specialty-relevant presenting complaints and to comply with LCME guidelines, students are required to log the Required Clinical Experiences into the web-supported tracking system throughout the clerkship.  This process is intended to help students meet educational goals of the clerkship.

POLICY:

1. Clerkships establish and publish a list of Required Clinical Experiences that students must complete to meet clerkship goals and requirements. Each clerkship also defines the appropriate clinical settings for these experiences, and the expected levels of medical student responsibility.
2. The Required Clinical Experiences are reviewed annually by the Clinical Curriculum Subcommittee to ensure relevance. The clerkship’s Required Clinical Experiences list can be found on the back of the Clerkship Cards handed out on the first day of each clerkship and in the MedInfo app, and students should enter their exposures to these diagnoses in an on-going fashion throughout the clinical years.
3. Students are also to enter their level of responsibility for each Required Clinical Experience. The levels of responsibility include:
• Observer,
• Perform Under Direct Supervision
• Perform Under Indirect, but Immediately Available Supervision.

4. Definitions of Levels of Responsibility:
• Observer – The student watches and does not perform
• Perform Under Direct Supervision - The student performs a task with the supervisor physically present in the same location as the student; able to provide direct instruction/feedback to the student; able to take over patient care duties if and when necessary
• Perform Under Indirect, but Immediately Available Supervision - The supervisor may not be physically present with the student; however, they are on-duty, immediately available, and can be called to the physical location of the student if and when necessary
5. Mid-way through each clerkship, students will meet with the Clerkship Director or another supervising physician and should bring a copy of the Required Clinical Experiences Summary Report to review in this meeting.
6. Each clerkship must have a mid-clerkship feedback session with every student. One of the goals of the session is to audit Required Clinical Experiences the student has completed and to check for any outstanding ones. The session allows the Clerkship Director or supervising physician to provide suggestions to the student in order to meet the requirement through patient care experiences. This also allows the Clerkship Director or supervising physician to provide the student a set of alternative learning experiences in the event that the student cannot complete all of the Required Clinical Experiences by the end of the clerkship rotation.

PROCEDURE:

1. Students must log their Required Clinical Experiences in One45 in an ongoing manner throughout the clerkship based on clerkship requirements.
2. Each student should discuss any outstanding Required Clinical Experiences with their Clerkship Director, Site Director or supervising physicians throughout the course of the rotation. If a student is unlikely to accomplish all of the Required Clinical Experiences through patient care experiences, despite best efforts, the student and site/course director should discuss alternate ways of learning that material.
3. Alternative activities will be scheduled on an individualized basis, based on the likelihood of the student getting the Required Clinical Experiences during their time remaining in the rotation.

ACCOUNTABLE DEAN OR DIRECTOR: Senior Associate Dean for Curricular Affairs

DATE APPROVED: June 2020

RELEVANT LCME STANDARDS:

9.7: Formative Assessment and Feedback
8.6: Completion of Core Experiences

PURPOSE AND SCOPE:

Students benefit from faculty feedback about their performance, both as an external measure of achievement and in informing how they may continue to improve. It is essential to provide feedback while a clerkship is in progress so that students have an opportunity to improve or to remediate deficiencies before the end of the clerkship.  This policy applies to clerkship directors, site directors, other supervising faculty physicians and residents, and medical students. 

POLICY:

• Students must receive feedback from supervising physicians and residents and/or clerkship or site director midway through the clerkship. This feedback must include review of the electronic log of required clinical experiences as well as an assessment of the student’s performance in comparison to clerkship objectives.
• This feedback must include review of the electronic log of required clinical experiences as well as an assessment of the student’s performance in comparison to clerkship objectives. See Required Clinical Experiences Policy.
• Clerkship Directors are responsible for ensuring each student receives mid-clerkship feedback.
• Students are able to comment on whether they received mid-clerkship feedback in the Clerkship Evaluation after each clerkship. Aggregate data on compliance with mid-clerkship feedback is distributed twice yearly to the Clinical Curriculum Subcommittee (CCS).

PROCEDURE:

• Mid way through a clerkship, the supervising physicians and residents, and/or clerkship or site director provides feedback to the medical student.
• Each student should discuss any outstanding Required Clinical Experiences with the supervising during the mid-clerkship feedback.
• Students log whether they have received mid-clerkship feedback in the clerkship evaluation form in One45. 

ACCOUNTABLE DEAN OR DIRECTOR:  Co-Directors of the Curriculum and Senior Associate Dean for Curricular Affairs

DATE APPROVED:  May 17, 2019

The Icahn School of Medicine at Mount Sinai uses the NBME Clinical Science examinations to assess student performance on the last day of each clerkship which occur in the third year. These standardized, objective, and discipline-based exams require medical students to solve scientific and clinical problems. Test scores reflect the learning specific to a student’s clerkship experiences, as well as their educational development resulting from the overall medical school experiences. Exams are designed to provide medical schools with an effective evaluation tool and useful examinee performance data that can be compared with a large representative group of examinees at the same stage of training.

Students are required to take the Shelf Exam on the last day of the clerkship as scheduled, and can expect to receive instructions on where to report for this from Blackboard and from the Clerkship Coordinator. The one exception is the Inpatient Medicine Clerkship, which takes the Medicine Shelf Exam in week 11 and the Family Medicine Shelf Exam in week 12 of the 12 week module. The standard Shelf Exam is 2.75 hours in length and online, though students will be required to arrive early to receive instructions.

Policy Regarding the Day before Shelf Exams

Students are expected to participate in clerkship activities the day before the Shelf Exam. However, students should not be assigned call responsibilities that day. All clerkship duties should end by 5 pm.

Before taking the required Sub Internship, a clinical refresher is strongly encouraged for those students returning from scholarly leave into Year 4. The student is encouraged to discuss the clinical refresher with the Faculty Advisor or Director of Electives.

General Information

Students must successfully complete a total of 14 weeks of elective credit in order to graduate.  For those students in the InterACT Program, a total of 10 weeks is required due to longer clerkship weeks required for the program.

Students may take clinical electives during the third and fourth years at the Icahn School of Medicine at Mount Sinai, our affiliates, or at off-campus scholarly institutions. Students may also design clinical or research electives or seek out international experiences via Global Health electives.

The following guidelines apply to all types of electives:

• Forty hours are required to receive one week of elective credit.
• For the 2020-2021 AY, there is no restriction on the number of one-week electives you are permitted to take one or more longitudinal electives that are listed in the Icahn School of Medicine electives catalog (Empower). There is no restriction on the number of longitudinal elective you can complete.
• You cannot take an elective concurrently with a required clerkship. Longitudinal electives may be taken concurrently with another non-required rotation (e.g. another elective) as long as the hours do not conflict.
• For the 2020-2021 academic year, there is no restriction on the maximum number of research or non-clinical electives
• Elective application forms must be submitted to the Office of the Registrar, with all required signatures, no less than two weeks prior to the desired start date of the elective.
• No retroactive credit will be granted for an elective.
• If a student wishes to repeat an elective that has already been taken, it is possible to do so, however, elective credit will not be given for the subsequent course(s).
• Any request for an elective greater than four weeks in length requires additional approval by the Senior Associate Dean for Student Affairs.
• Preparation for USMLE Step 1 by completing the Step 1 Board Review Course attended remotely or completed asynchronously on-line with attestation, can count as two weeks of elective credit. Empower registration is required.
• Preparation for USMLE Step 2 CK is built into the Year 4 schedule with a Step 2 CK Board Review course that, if attended in its entirety or completed on-line with attestation, counts as two weeks of elective credit.  Empower registration is required..
• Work completed for remediation (including remediation for Step 1 and/or Step 2) is not eligible for elective credit.
• Students on a Scholarly year or on the PHD portion of their MD/PhD training cannot receive elective credit.

To receive full credit for an elective you must complete each step of the elective process:

1. Select and register for the elective.
2. Complete the elective.
3. Ensure that your mentor/preceptor has submitted an evaluation of your performance.
4. Complete your evaluation of the elective.

Selecting and Registering for an Elective

Icahn School of Medicine Electives

• Browse the online electives catalog.
• Select the elective for which you wish to apply and click the “Register for Electives”  button on the detailed view screen
• You will receive three emails generated from the system during the registration process:
• An email informing you that you have requested the elective and it is PENDING DEPARTMENTAL APPROVAL
• Next, an email informing you that the department has approved the elective and it is PENDING REGISTRAR APPROVAL
• A final email informing you that your request to add the elective has been APPROVED BY THE REGISTRAR
• You must receive the final email to be fully registered for the elective and receive credit; no retroactive credit will be applied.
• Your login is your student email address and your password is your life number. You should change your password once you have successfully logged into the EMS under Account Management.
• You may access your account anytime online
• If you have any issues with the approval process, contact the Assistant Registrar or the Director of Student Electives.

Clinical Tailor-Made Electives

• Students wishing to design their own clinical elective(s) with a specific Icahn School of Medicine faculty member or a faculty member from an outside institution may do so by submitting the Elective Registration: Clinical Tailor-Made form to the Office of the Registrar. The form can be accessed online via the Medical School Forms web page.
• Once you have completed the form, it needs to be reviewed and approved by the following: Office of the Registrar, Mentor/Preceptor, and the Director of Student Electives.

Tailor-Made Research Electives

• Students wishing to design a research or a non-clinical elective with a specific Icahn School of Medicine faculty member or mentor from an outside institution may do so by submitting the Elective Registration: Tailor-Made Research Elective form (MD, MD/PhD, or MD/MPH)to the Office of the Registrar. The form can be accessed via the Medical School Forms web page.
• Once you have completed the form, it needs to be reviewed and approved by the following people: Assistant Registrar, Mentor/Preceptor, and the Director of the Medical Student Research Office.

Electives at Other Schools and Institutions

VISITING ELECTIVES ARE SUSPENDED FOR ACADEMIC YEAR 2020-2021

In accordance with AAMC guidance and due to the COVID-19 pandemic, students are not permitted to participate in electives at institutions outside of the Icahn School of Medicine at Mount Sinai. Some schools are offering virtual electives, which are listed in the VLSO catalog or on their school website.

Tailor-Made Electives at Other Schools

ELECTIVES AT OTHER SCHOOLS ARE SUSPENDED for ACADEMIC YEAR 2020-2021

Global Health Electives

GLOBAL HEALTH ELECTIVES ARE SUSPENDED FOR ACADEMIC YEAR 2020-2021

Year 3 Students and Away Electives

Note: Away electives are suspended for Academic Year 2020-2021 due to the COVID-19 pandemic, in accordance with the AAMC guidance.

In general, the Icahn School of Medicine students wishing to do away electives will do so in the fourth year. From time to time, a student may have a reason to do an away elective during elective time in Year 3. The following should be considered:

• Students must meet the prerequisites set by the institution they are visiting.
• Students should recognize that they may not be as prepared as they would be in Year 4 with the benefit of all or most of the clinical clerkships. In general, assessments done at the away elective is set at a standard for a Year 4 student.
• Students may not know the “system” and logistics at an away location and with a shorter allotment time of elective in Year 3, it may be difficult to acclimate to new systems in time to be able to have an effective elective.
• Any elective done outside of an LCME-approved school must have the approval of an Icahn School of Medicine at Mount Sinai Director of Student Electives and that approval must acknowledge that this mentor approves the elective for the student in Year 3.
• If there are any questions or concerns, students are encouraged to meet with the Director for Student Electives or their Faculty Advisor to discuss.

Ensuring that your Mentor/Preceptor has Submitted an Evaluation

Electives at Icahn School of Medicine

Towards the end of your elective, including away electives, you must deliver to the mentor/preceptor the Elective: Evaluation/Grade Form, available on the Medical School Forms web page, which the mentor/preceptor will complete and return to the Registrar's Office at the conclusion of the elective. It is the student’s responsibility to ensure that this form is completed and returned to the Office of the Registrar (Email: electives@mssm.edu or Fax: 212-369-6013) at the conclusion of the elective.

Electives at other schools

If you are doing an elective at another institution and they wish to use their own institution’s form for evaluation rather than the Icahn School of Medicine form, the mentor/preceptor may complete their institution’s form and submit that to the Office of the Registrar. It is the student’s responsibility to follow-up with those schools to receive your grade and communicate that to the Office of the Registrar.

How Electives are Graded

All electives are graded Pass, High Pass, Honors or Fail.

Completing an Evaluation of the Elective

Electives at Icahn School of Medicine

All third- and fourth-year students are required to evaluate each elective experience AND the preceptor through our evaluation system using their existing login and password. Evaluations assist us in understanding and evaluating the effectiveness of the electives. Evaluations must be completed no later than four weeks after receiving a notification via email. If a student does not complete the mandatory evaluation four weeks after receiving notification, the student will receive an Incident report and no credit for the elective. Please refer to Student Conduct section of Handbook on Incident reports. If the MSPE has been submitted, it will be amended and re-uploaded to reflect this breach of professionalism. The evaluations must be filled out in order to receive credit for the elective.

Electives Review System
Students are encouraged toensure that they are on track with meeting their elective requirements for graduation by logging in to their Empower account. 

Medical Liability Coverage

The Icahn School of Medicine at Mount Sinai provides medical students with medical liability when providing medical services as a part of approved educational activities. Students are not covered while participating in unapproved activities or rotations. During students’ third and fourth years, coverage does not apply for an activity unless the entire registration process has been followed and the activity has been officially listed on your schedule. To assure that you are covered for a specific activity, inquire in the Office of the Registrar’ or view your student transcript on the Empower Student Information System. When rotating outside the School of Medicine, you may be requested to provide a letter from the School showing proof of coverage; that letter may be obtained from the Office of the Registrar, by completing the document request form on the Registrar web page.