AUC Clinical Sites

Bronx-Lebanon Hospital, one of AUC’s affiliated clinical rotation sites

When Do We Do Clinical Rotations?
Third and Fourth years of med school. After we complete our first five semesters of Basic Science training on the island, we go back to the states (or Canada) and take the USMLE Step 1 board exam within a semester’s worth of time. Once we pass the exam, we work with our clinical advisors and schedule our clinical rotations (aka “clerkships”) for our third and fourth years of med school. Rotations are scheduled on a first come first serve basis. Your advisor will let you know which rotation spots are available and let you choose among the spots available. You can schedule all your rotations at once, or schedule a few now and the rest later. If you are flexible, there is always a clinical spot available somewhere among AUC’s affiliated hospitals at any point of time. You will never have to delay your education just because there is no spot available.

How Many Weeks are Clinical Rotations?
In total, we do 72 weeks of rotations during our third and fourth years of medical school. We do 42 weeks of Core clinical rotations and 30 weeks of Elective clinical rotations.

What Are The Core Clinical Rotations?
The five core rotations that all med students must do are Internal Medicine (12 weeks), General Surgery (12 weeks), Pediatrics (6 weeks), OB/GYN (6 weeks), and Psychiatry (6 weeks).

Are There Any Recommended Elective Rotations?
AUC highly recommends us completing Family Medicine (can be 4 or 6 weeks, depending on the site) and Neurology (4 weeks) electives. Many states such as California (Code 2089.5) require Family Medicine for licensure. Neurology used to be required for Texas, but is no longer a requirement for licensure in any state (but double-check with AUC, because laws may change). However, because many (if not most) US medical schools require it as a core clerkship, it would look better on your part if you have it done when it comes time for applying to residency programs. It’s also important to note that many residency programs may require that you complete certain electives in order to be considered for their program (i.e. Emergency Medicine rotation for some Family Medicine residency programs). To be on the safe side, I would recommend everyone taking Family Medicine and Neurology electives. And obviously, take an elective of the specialty you want to pursue (i.e. Pathology rotation for Pathology residency, Pediatric sub-internship for Pediatrics residency).

Can We Do Elective Rotations Before Core Rotations?
Generally, we do core rotations before elective rotations, mainly because core rotations are more fundamental and elective rotations are usually sub-specialties of those fundamental core fields. There are four elective rotations that we are allowed to do before starting core rotations: Family Medicine, Neurology, Pathology, and Radiology. For all other sub-specialty electives, one must first complete the core rotation in which it is a sub-specialty. For example, you must first complete your internal medicine core rotation before you can do an elective rotation in endocrinology, since endocrinology is a sub-specialty of internal medicine.

Where Can We Do Our Clinical Rotations?
We are required to do all of our core rotations at AUC’s affiliated teaching hospitals, most of which are located in the US, but also the UK. For elective rotations, we generally also complete them at AUC’s affiliated hospitals, but we also have the flexibility to complete some electives at non-affiliated hospitals as well. According to a newly-passed nation-wide law, we are allowed 8 weeks of our rotations at each institution/hospital not affiliated with our school.

What Does It Mean For A Rotation To Be “Greenbook”?
It means that the rotation is at a teaching hospital that has an Accreditation Council for Graduate Medical Education (ACGME)-accredited residency or fellowship program in the specialty you want to do the rotation in.

Are All of AUC’s Clinical Sites Greenbook?
All of AUC’s clinical core rotations are greenbook except Pediatrics at Kern (in California), which is bluebook because it falls under the umbrella of Family Medicine at this site. This rotations satisfies the requirements for California and almost all the other states for licensure, but may cause issues in Texas. If you decide to go this route, you can still get a residency in Texas, but your licensing in Texas would be delayed until after you are board certified. To ensure you’ll have no issue with licensing in Texas, I personally would just do pediatrics at another one of AUC’s many affiliated teaching hospitals.

I Don’t See Pediatrics or Psych rotations at Providence Hospital Being Listed on the ACGME Site. Is It Really Greenbook?
The Pediatrics rotation at Providence is actually done via Providence’s sister hospital of St. John’s Hospital, which is listed on ACGME, and therefore is greenbook. The Psych rotation at Providence is administered via University of Michigan, which is also listed separately on the ACGME site, and is therefore also Greenbook. There’s a couple more examples of these types of listings. Yes, the way the approved clinical rotations are listed on the site can be a little confusing sometimes, but you can be sure that all of AUC’s clinical rotation sites (except Peds at Kern) are greenbook.

Is There Only One Hospital We Rotate at Each Clinical Rotation Site?
Not always. For example, if you decide to rotate at Center for Haitian Studies (CHS), you’ll actually be rotating at any one of CHS’s affiliated hospitals: Miami Children’s Hospital, University of Miami Hospital, Jackson Memorial Hospital, Aventura Hospital, or Mt. Sinai Hospitals, all of which are major teaching hospitals for several medical programs in the south Florida area. We’re not just limited to that one hospital.

When are the start dates for clinical rotations?
It depends on the clinical site. Some sites like Providence only have 2 or 3 start dates per year. Other sites, like Miami, have new start dates every 6 weeks. In the UK, you can generally start your rotations any week.

Which Hospitals Can I Do All 5 Core Rotations?
In the US: Bronx-Lebanon Hospital, Providence Hospital, Nassau University Medical Center, Kern (but keep in mind the Pediatrics here fall under “Family Medicine” and therefore can be an issue for licensure in some states).
In the UK: Ealing Hospital, Epsom General Hospital, and Royal Blackburn Hospital. If you choose to go to a hospital that does not offer all the cores, as a third or fourth semester student, you may have to do some traveling, but some people may like to experience different hospitals and make useful connections.

Will I Have Issues With Licensure If I Do Rotations in the UK?
No. All of AUC’s affiliated teaching hospitals in the UK are considered “Greenbook” and completely meet the requirements. Personally, I feel it would be an awesome experience to get trained in the UK for at least one of my core rotations and then return to the US to complete my third and fourth year of medical school.. I hear from several students and alumni that clinical training in England is more hands-on, and trains you well to impress your attendings once you come back to the states. Not to mention, being trained by two healthcare systems is an invaluable opportunity.

**UPDATE 2/2014** I have gone to the UK for my Psychiatry and Surgery core rotations, and I have finished my residency interviews. Many programs I interviewed with were actually very fascinated about my experience in the UK. It is an experience that many of their other applicants may not have had and made me stand out in a good way.

Are There Exams We Take After Each Rotation?
For each clinical rotation, we take the NBME Shelf Exam for that rotation. It counts towards our clinical grades at AUC, which is pass/fail. These exams are nationally administered and can be taken at various testing centers in the states. More importantly, after finishing our core rotations, we’ll have to take the second part of our board exams: the USMLE Step II. The Step II exam consist of a Clinical Knowledge portion (USMLE Step II ck) and a Clinical Skills portion (USMLE Step II cs). These exams are also administered at various hospitals around the country.

Where Can I Learn More About AUC’s Clinical Rotations?
Every semester, AUC’s Office of Clinical Student Affairs (OCSA) come down to the island to give a presentation/workshop about clinicals. It is open to the entire school and is a great way to get more information and get your questions answered about clinicals, as well as meet your clinical advisors. In addition, every May, AUC holds a Clinical Symposium in which representatives from most of AUC’s affiliated clinical teaching hospitals in the US and UK come to the island to talk to Basic Science students about their hospitals. You meet and talk to the people directly running the show and get a much better sense of what the sites and rotations are like. You can also contact the Office of Clinical Student Affairs directly to get any questions answered.

What are AUC’s Affiliated Teaching Hospitals?
For a complete and updated list of AUC’s clinical teaching hospitals, please visit here. Here is a list that I have compiled (updated January 22, 2013):

Med Surg Ped Ob/G Psych
Baton Rouge General Hospital Baton Rouge, LA X X
Bayfront Medical Center St. Petersburg, FL Electives only
Brentwood Hospital Shreveport, LA X
Bronx-Lebanon Hospital Center Bronx, NY X X X X X
Brooklyn Hospital Center Brooklyn, NY X X X X
Center for Haitian Studies Miami, FL X X X X
Cleveland Clinic Weston, FL Electives only
Crittenton Hospital Medical Center Rochester Hills, MI ?  ? ? ? ?
Flushing Hospital Queens, NY X X X X
Griffin Hospital Derby, CT X X
Kaiser Permanente LA Fontana, CA Electives only
Kern Medical Center Bakersfield, CA X X X X X
Mount Sinai Medical Center Chicago, IL Electives only
Mount Vernon Hospital Mount Vernon, NY X
Nassau University Medical Center East Meadow, NY X X X X X
Orlando Regional Hospital Orlando, FL Electives only
Providence Hospital Southfield, MI X X X X X
Shands at the University of Florida Gainesville, FL Electives only
Spring Grove Hospital Center Catonsville, MD X
St. Agnes Hospital Baltimore, MD X X
St. John Hospital and Medical Center Detroit, MI X
St. John’s Episcopal Hospital Queens, NY X
St. Luke’s Roosevelt Hospital Center New York, NY Electives only
St. Mary’s Hospital Waterbury, CT X
Staten Island University Hospital Staten Island, NY X X X X
Tallahasee Memorial Hospital Tallahassee, FL Electives only
Union Memorial Hospital Baltimore, MD X X
Washington Adventist Takoma Park, DC X
Med Surg Ped Ob/G Psych
Ealing Hospital London, UK X X X X X
Epsom General Hospital Epsom, UK X X X X X
Queen’s Hospital Romford, UK X X X X
Royal Blackburn Hospital Blackburn, UK X X X X X
Stepping Hill Hospital Stockport, UK X X X X X
Wexham Park Hospital Slough, UK X X X X X
Worthing District Hospital Worthing, UK X X X X