Internal Medicine, Consultative Outpatient (Minnesota)


This is a four-week elective in outpatient general internal medicine. Due to the variety of patients seen in this large general medicine division, a rotation can be tailored to a student’s interest. The experience can emphasize preoperative medical evaluation, women’s health issues, men’s health issues, preventive medicine, or increasing general medical problem solving and physical exam skills.

The Division of General Internal Medicine provides care to national and international patients seeking evaluation of a difficult medical problem or a comprehensive evaluation of their health status. Students will be directly supervised by a staff physician. The student and staff will work together to formulate differential diagnoses, guide diagnostic evaluations, and synthesize the studies and consultations obtained into a therapeutic plan for these complex patients. Patients are also offered in-depth counseling on preventive care issues, and students will be expected to become proficient at performing appropriate counseling. Students will have a chance to work with staff physicians seeing medical consultations and performing preoperative risk assessment at the request of colleagues in other departments. Students will also have an opportunity to work in consultative clinics, including the Breast Clinic, Women's Health Clinic, Alternative Medicine Clinic and Travel Medicine Clinic. Educational conferences are held weekly, including case conferences, morbidity and mortality conference, grand rounds, and journal clubs. All internal medicine residency and Mayo Clinic School of Medicine conferences are available to students.

Specific goals

  1. Increase and apply knowledge regarding general medical issues and preventive care
  2. Enhance interviewing skills, physical exam skills, and ability to develop a problem list and appropriate differential
  3. Review common general medicine problems and apply knowledge to patients
  4. Learn how to conduct a preoperative evaluation
  5. Learn how to independently and efficiently research questions that arise during care of complex general medicine outpatients
  6. Appreciate the role of the consultative general internist
    • Feel reward in solving a diagnostic dilemma
    • Be stimulated to find evidence to answer clinical questions
    • Appreciate the complex interplay of psyche and soma

Additional goals may be defined following discussion with the clerkship director and the student. Examples:

  • Increase knowledge of women's health issues
  • Become proficient at providing pre-travel advice
  • Learn how to use Web-based medical resources

Activity outline

  • Perform general medical evaluations in conjunction with staff physicians each morning. Time will be devoted each morning for patient-related teaching
  • Spend afternoons seeing returning patients, performing perioperative evaluations, and learning through self-direction
  • Spend a few days or week(s) in consultative clinics depending on a student's interest
  • Attend noon and morning educational conferences that are related to the student's educational goals
  • Establish an educational contract with each preceptor at the beginning of the experience to help define what the preceptor and the student will concentrate on during their time together. This will be reviewed between the preceptor and student following completion of the experience.
  • Keep a journal regarding diagnoses, lessons, unanswered questions, and topics reviewed to help crystallize learning and help define topics that need to be covered as the clerkship progresses
  • Present a patient and review a related topic at the General Internal Medicine (GIM) Friday noon conference at the end of the rotation. The presentation should be 20–30 minutes.

Building your clerkship

  • Two to four weeks of outpatient general internal medicine consultative experience
  • Up to two weeks in specialty medicine clinics, including:
    • Breast Clinic
    • Travel Medicine Clinic
    • Women's Health Clinic
    • Alternative Medicine Clinic

Method of evaluation

Students will receive weekly oral feedback from their preceptors, whose purpose is to improve clinical skills. Preceptors will provide the clerkship director with a written assessment of clinical skills, initiative and oral presentations. The clerkship director will summarize the written information provided by the student’s preceptors and return a final grade to students and their medical school.