Phases III and IV—Doctoring

<p>Phases III and IV of the Physicianship Curriculum focus on clinical knowledge, skills, judgment, and discernment—in short, on “doctoring.” Phase III learning activities occur mainly in clinics, day hospitals, and other outpatient settings; phase IV is in hospitals or other contexts for care of persons with acute illnesses. Students serve as members of health care teams and attending teachers ensure that, whenever possible, instruction involves actual patients encountered by the students. This is designed to provide role models of bedside (and patient-side) behaviors and avoid the depersonalization of paper- (or computer-) based reviews of clinical “cases.” Phase III has four 12-week modules addressing 12 clinical disciplines. Phase IV includes four 6-week modules in mandatory rotations and additional time for electives. Direct patient contact is emphasized, supplemented by case-based teaching, journal clubs, and sessions on imaging and other diagnostic tools. An important goal is to foster critical appraisal.</p>