MD-level competence in internal medicine. Objectives and the flexible clerkship

The faculty of the Department of Medicine at the John A. Burns School of Medicine, University of Hawaii, Honolulu, defined MD-level competence as the capability of undertaking the first day of a primary-care internship. To meet this goal, a curriculum was developed that used a written statement of expected competencies and objective measurements of student performance. The duration of the clinical clerkship was made flexible to acknowledge the normal variation in the rate at which students learn. Six weeks of ambulatory patient care were included in the basic third-year clerkship to fulfill objectives otherwise unmet.