Class of 2026: Welcome to Phase 3!

Dear Class of 2026,
 
Welcome to Phase 3 of your medical education! We know many of you are excited to begin your senior rotations and are studying for your Step 2 exam. We want to ensure you have the resources needed over the coming months as you navigate the exciting year ahead.
 
Many students arriving at Phase 3 are adjusting to increased expectations. You have come a long way since beginning your clerkships and have amassed considerable knowledge. You also have much to accomplish to start practicing medicine on your first day of residency just months from now.

Preceptor Expectations 

• Assess your patients independently: Faculty and residents will expect you to obtain an appropriate history and perform a relevant physical examination on all patients under your care.
• Develop an accurate differential diagnosis: Specifically mention the differential in oral presentations and written notes.
• Propose an appropriate management plan: Your plan should relate to your differential diagnosis and incorporate the patient’s values and preferences. It should include the diagnostic plan, the management of symptoms, follow-up, and social determinants of care.
• Perform tasks under physician supervision: To the maximum extent permitted by existing systems and in preparation for your intern and residency years, you should enter orders, write notes, and perform appropriate procedures, consultations, patient education, and discharge planning under physician supervision in all your patient encounters.

Perhaps most importantly, your preceptors will expect you to identify your learning goals and gaps as you prepare for transition to residency. You are all preparing for different career pathways. Each student has unique strengths and weaknesses. Participate in as many patient encounters as you can, read about your patients and interesting cases, and push yourself to learn as much as possible over the next few months.

We hope you find this a fulfilling and exciting year of your training as you continue to develop your health care role and hone your skills.

Just in case you need it, the Student Handbook has all the policies and details that are relevant for you. Here are some policies to highlight: 

Graduation Requirements

Please review the Graduation Requirements for Phase 3. Learn more about Phase 3 required rotations here.

Grading & Exams

• Grade Policy: All Phase 3 rotations are graded Satisfactory/Fail (S/F), including Sub-Internships, Critical Care Selectives, Radiology, Emergency Medicine, Electives and Transitions 3. Please review the specific syllabus for details about the grading breakdown for each clerkship/course/selective. For any questions, reach out to your clerkship/course/selective directors.
• Phase 3 NBME Exams: The only Phase 3 NBME exam is the Emergency Medicine clerkship. During EM, the NBME exam will occur at the rotation's end and is typically offered on two separate days to provide some schedule flexibility.
• EM Clerkship Information
  • Please enter your required EM orientation, simulation, and exam days into your calendar immediately to avoid schedule conflicts in the future.
  • A mid-rotation practice NBME exam is required in the EM clerkship. This exam will help you gauge where you are in preparation for the final NBME exam.
    
    

Time Away

• Residency Interview Time Away: IU School of Medicine allows students to reschedule educational activities, whenever possible, for residency interviews. Our ability to accommodate schedule changes depends on effective and timely communication. Please review the Guide to Time Away for Phase 3 for guidance on scheduling flexibility for interviews.
  
  

Travel Guidelines

• If you need to travel to a different campus for a required clerkship/selective or elective, review the Phase 3 Scheduling Guidelines and the MSE Travel Guidelines, which include information regarding housing, mileage reimbursement, and parking.
  

Phase 3-Specific Noteworthy Accreditation Standards/Policies

• Work Hours: Medical students on clinical rotations must not exceed an 80-hour work week averaged over a four-week period. Students must be provided with at least one day off per seven-day period averaged over four weeks. These restrictions are best practice and consistent with ACGME policies in residency. Work-hour restrictions apply to both electives and required rotations; however, you only need to log work hours in MedHub during your EM, Critical Care, and Sub-I rotations. Here is a tutorial on how to log work hours.

• Supervision & Scope of Practice Policy: Any concern about inappropriate supervision during your rotations can be reported here. Someone will follow up with you.

• Time Away Policy: Please review this policy for questions about absences from clinical rotations and interview requests. You can also access the Time Away Request Form.

• Conflicts of Interest in Supervision and Evaluation: Students should not be evaluated by any individual who has a current or prior relationship that could reasonably be perceived as a conflict of interest. This includes familial relations, currently or previously providing medical or mental healthcare to the student OR if either party feels that there is a conflict of interest. Students who believe there may be a conflict of interest in assessment should contact the clerkship/selective/elective director immediately upon discovering the issue. Any resulting issues will be handled with confidentiality and respect for all parties.

• Learning Environment, Mistreatment Policy & Procedures: We value fostering a positive learning environment through your entire medical training experience. We know you are probably familiar with this policy and procedure for reporting mistreatment issues, but if ANY issues occur, please discuss it with someone for assistance and support.

• Non-Mistreatment Concerns Reporting: Students may also report non-mistreatment-related concerns and incidents in the learning environment. Concerns can be reported anonymously; per IU policy, retaliation against anyone submitting a report is strictly prohibited. Student concerns NOT related to mistreatment may include:

• Involvement of a student’s prior healthcare provider in teaching/assessment
• Inadequate clinical supervision
• Lack of access to secure storage, study, or relaxation spaces in academic or clinical settings
• Excessive work hours
• Too many learners on clinical experiences
• Failure to excuse for necessary health appointments
• Microaggressions or bias in curricular content.

• Infectious Disease and Environmental Hazards Policy (i.e., Needlestick): Please review this policy addressing how to effectively manage student exposure to infectious and environmental hazards.

Always check with your specific clerkship/selective/elective leadership team for clarification about any of the above policies and procedures as they relate to their clerkship/selective/elective. If you have any areas that need clarification, please do not hesitate to reach out to your Lead Advisors, Student Affairs Deans, or me (Megan Christman) for assistance. Direct any general questions to AskMSE.

On behalf of the entire Phase 3 Curriculum team, we hope this is a successful and exciting year for you. We are excited to help you grow into your roles as outstanding physicians!

Megan Christman DO, FACOG (She/her/hers)