Journal of General Internal Medicine

, Volume 34, Issue 5, pp 699–704 | Cite as

A National Survey of Undergraduate Clinical Education in Internal Medicine

  • Amber T. PincavageEmail author
  • Mark J. Fagan
  • Nora Y. Osman
  • Debra S. Leizman
  • Deborah DeWaay
  • Camilla Curren
  • Nadia Ismail
  • Karen Szauter
  • Michael Kisielewski
  • Amy W. Shaheen



In the present milieu of rapid innovation in undergraduate medical education at US medical schools, the current structure and composition of clinical education in Internal Medicine (IM) is not clear.


To describe the current composition of undergraduate clinical education structure in IM.


National annual Clerkship Directors in Internal Medicine (CDIM) cross-sectional survey.


One hundred twenty-nine clerkship directors at all Liaison Committee on Medical Education accredited US medical schools with CDIM membership as of September 1, 2017.

Main Measures

IM core clerkship and post-core clerkship structure descriptions, including duration, educational models, inpatient experiences, ambulatory experiences, and requirements.

Key Results

The survey response rate was 83% (107/129). The majority of schools utilized one core IM clerkship model (67%) and continued to use a traditional block model for a majority of their students (84%). Overall 26% employed a Longitudinal Integrated Clerkship model and 14% employed a shared block model for some students. The mean inpatient duration was 7.0 ± 1.7 weeks (range 3–11 weeks) and 94% of clerkships stipulated that students spend some inpatient time on general medicine. IM-specific ambulatory experiences were not required for students in 65% of IM core clerkship models. Overall 75% of schools did not require an advanced IM clinical experience after the core clerkship; however, 66% of schools reported a high percentage of students (> 40%) electing to take an IM sub-internship. About half of schools (48%) did not require overnight call or night float during the clinical IM sub-internship.


Although there are diverse core IM clerkship models, the majority of IM core clerkships are still traditional block models. The mean inpatient duration is 7 weeks and 65% of IM core clerkship models did not require IM-specific ambulatory education.


undergraduate medical education clerkship internal medicine clerkship 



The authors would like to thank the CDIM Survey and Scholarship Committee, CDIM Council members, and all CDIM members.

Compliance with Ethical Standards

The survey protocol was granted full institutional review board exempt status from the University of North Carolina Office of Human Research Ethics.

Conflict of Interest

The authors declare that they do not have a conflict of interest.

Supplementary material

11606_2019_4892_MOESM1_ESM.docx (30 kb)
ESM 1 (DOCX 29.5 kb)
11606_2019_4892_MOESM2_ESM.docx (13 kb)
ESM 2 (DOCX 12.7 kb)


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Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Amber T. Pincavage
    • 1
    Email author
  • Mark J. Fagan
    • 2
  • Nora Y. Osman
    • 3
  • Debra S. Leizman
    • 4
  • Deborah DeWaay
    • 5
  • Camilla Curren
    • 6
  • Nadia Ismail
    • 7
  • Karen Szauter
    • 8
  • Michael Kisielewski
    • 9
  • Amy W. Shaheen
    • 10
  1. 1.Department of MedicineUniversity of Chicago Pritzker School of MedicineChicagoUSA
  2. 2.Department of MedicineAlpert Medical School of Brown UniversityProvidenceUSA
  3. 3.Department of Medicine, Brigham and Women’s HospitalHarvard Medical SchoolBostonUSA
  4. 4.Department of MedicineUniversity Hospital Cleveland Medical Center, Case Western Reserve University School of MedicineClevelandUSA
  5. 5.Department of Internal Medicine, Morsani College of MedicineUniversity of South FloridaTampaUSA
  6. 6.Department of Internal MedicineThe Ohio State University College of MedicineColumbusUSA
  7. 7.Department of MedicineBaylor College of MedicineHoustonUSA
  8. 8.Department of Internal MedicineUniversity of Texas Medical BranchGalvestonUSA
  9. 9.Alliance for Academic Internal MedicineAlexandriaUSA
  10. 10.Department of Internal MedicineThe University of North CarolinaChapel HillUSA

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