Clerkship courses

This is a general overview of the Clerkship courses for third year and fourth year.  For a description of the Clerkship Curriculum, refer to the Academic Calendar. Course details, including learning objectives and assessment breakdowns, can be found on the course's website on Elentra (UTORid required).  For information about course contacts, see clerkship Course Directors and Administrators.

Third year

Transition to Clerkship (TTC 310Y)

The two-week Transition to Clerkship (TTC) course assists students in developing the knowledge, skills and attitudes necessary to transition from being a student in the Foundations curriculum, to being a member of the healthcare team as a clinical clerk. The course builds on the very substantial learning from the first two years of the MD program and provides students with the opportunity to immerse themselves in the skills required to begin clerkship rotations through a variety of immersion and onboarding learning activities (including simulations, online modules, academy and campus-based seminars and shadowing experiences). An emphasis is placed on intrinsic CanMeds skills and specific medical expert competencies. TTC core curriculum activities consist of both large and small group interactive seminars/workshops, and several required online learning modules. Academy Orientation and Academy Clinical Skills Days incorporate some registration tasks (e.g. mask-fit testing, computer systems training) along with practical skills (order writing, managing violent patients). The third-year Dermatology course also takes place within TTC.

Anaesthesia (ANS 310Y)

The two-week Anaesthesia course is based on a 'flipped classroom' model. Students are required to complete seven e-modules where faculty is available via a discussion board. The rotation includes two days of simulation training at Sunnybrook Health Sciences Centre. The first day includes a comprehensive training on IV skills, airway management and fluid responsiveness using ultrasound. Case scenarios are used to teach ACLS protocols and communication skills during critical events in a simulated operating room. During the exit simulation day, the students rotate through preoperative, intraoperative and postoperative scenarios that reinforce the content in the e-modules and work through integrated cases that highlight module content. For clinical shifts, you are assigned to a faculty staff member in the operating room, labour floor, pre-admission clinic, or pain service where one on one teaching is provided. You assist in all aspects of anesthetic care. There is no overnight call.

Dermatology (DER 310Y)

The Dermatology course is held within the Transition to Clerkship (TTC) course. Clerks attend a patient viewing day, complete online modules, and submit a clinical note. In addition to the aforementioned course work, course materials in the form of a syllabus and online atlas are provided to you, covering all the topics that they are expected to learn during their Dermatology course. The entire course content is posted on Blackboard. 

Emergency Medicine (EMR 310Y)

The four-week Emergency Medicine course commences with three days of hands-on workshops and seminars utilizing simulation, skills-based teaching, and case-based interactive sessions. These sessions provide opportunities to acquire essential knowledge and skills in preparation for clinical experience, and cover topics that include medical imaging, airway management, cardiac dysrhythmias, trauma, ultrasound, toxicology, chest pain, wound management, and splinting. Students are then placed at one of the ten Emergency Departments in the Greater Toronto Area to complete 15 shifts, including up to two weekends and three overnight shifts. During the clinical experience you function as members of an interprofessional team and are assigned one or two preceptors with whom at least half their shifts occur. Each clerk spends half a shift with members of the interprofessional team. You learn to manage many types of patient problems that present to the Emergency Department, including exposure to core emergency medicine cases. There are additional opportunities to perform basic procedures (intravenous insertion, venipuncture, foley catheter insertion, NG insertion, ECG) and observe the triage process. 

Family and Community Medicine (FCM 310Y)

The six-week Family and Community Medicine course begins with centrally delivered core seminars for the first two days. Core seminars include: orientation, family violence, motivational interviewing, global health, palliative care and geriatrics. After core seminars, the students go to their respective sites to start the clinical portion of the rotation. You experience family medicine at a family medicine teaching unit or a community family physician’s office or a combination of both teaching environments. A small number of rural placements are also available through the Rural Ontario Medical Program (ROMP) . The course exposes students to various comprehensive care models and strives to have students learn in an interprofessional environment. You also participate in site-based seminars and complete e-modules. 

Internal Medicine (MED 310Y)

The eight-week Internal Medicine course begins with an interactive, case-based seminar series for two and a half days. Additional seminars occur approximately once per week for the remaining weeks. Each clerk is assigned to a single Internal Medicine Team for the entire rotation. A sub-group of students may choose a two-week ambulatory care experience in the current academic year. Over the entire length of the course, there is a graduated experience with increasing responsibility. You have the opportunity to perform the admitting history and physical examinations on patients who present to the Emergency Room, and are asked to provide a provisional diagnosis and differential diagnosis, and to construct an investigation and management plan. You also provide direct patient care for your assigned patients under supervision. Later in the rotation, you carry up to six patients and have enhanced responsibilities for patients while on call. Support is provided by other members of the team, including the attending physician and supervising residents. You are also assigned to six half-days in ambulatory clinics so that you have an opportunity to learn about how care is delivered to medical patients in this setting. 

Obstetrics and Gynaecology (OBS 310Y)

The six-week Obstetrics and Gynaecology rotation offers a variety of clinical activities related to all aspects women’s health care, including rotations in labour and delivery, inpatient antenatal and postpartum units, antenatal clinics, gynaecologic ambulatory care, inpatient gynaecology units, the operating room and the emergency department. In addition to clinical activities, you attend daily small-group teaching seminars on a range of obstetrical and gynaecological topics. Further to the seminar series, each hospital site also conducts its own set of teaching and/or grand rounds which you are expected to attend. Students are assigned to one of eight teaching hospital sites. 

Ophthalmology (OPT 310Y)

The one-week ophthalmology course begins with a clinical skills review and orientation session. Throughout the week, you see a variety of ambulatory ophthalmology patients in eye clinics or in the offices of attending ophthalmologists. In clinic, you examine patients, which may involve taking an ophthalmic history and performing relevant ocular examinations, as well as formulating a differential diagnosis and management plan. Students may attend the operating room for a half day. You are expected to research each assigned patient’s disease using appropriate texts and journals and review course topics including: cornea and anterior segment (the red eye), lens and optics, glaucoma, retina, uveitis and inflammatory diseases, neuroophthalmology, oculoplastics and orbital diseases, paediatric ophthalmology and strabismus, and ocular emergencies and trauma. In addition, all students attend seminars on paediatric ophthalmology at the Hospital for Sick Children.

Otolaryngology-Head & Neck Surgery (OTL 310Y)

The one-week Otolaryngology course includes site-specific teaching sessions and clinical experience in outpatient clinics. The remainder of the time is spent on the wards, in the operating room, on seminars and self-directed learning with otoscopy and nasal packing simulators and online cases. The rotation includes a series of online seminars, covering common and important topics in otolaryngology including hearing loss, vertigo, epistaxis, rhinosinusitis, emergencies, and head and neck malignancies. You are also given a paediatrics otolaryngology seminar, an Otosim seminar, and an audiology lecture at the Hospital for Sick Children. Attendance in the operating room is available to students and may be arranged at their Academy with the site director at the beginning of their rotation. 

Paediatrics (PAE 310Y)

The first two days of the six-week Paediatrics course are devoted to an academic teaching program at SickKids. During this rotation students are exposed to a combination of ambulatory and inpatient paediatrics. Students are either placed in a paediatric setting in a Community Hospital, at The Hospital for Sick Children in a combination of paediatric wards and Paediatric practices, or their Paediatric Emergency Department and ambulatory Paediatric practices. You will complete Computer Assisted Learning in Pediatrics Cases (CLIPP) which offer comprehensive interactive cases that cover important core topics. 

Portfolio (PFL 310Y)

The third year Portfolio course is designed to facilitate your professional development through guided reflection. It focuses on all the activities in the clinical phase of your journey and how they relate to the six 'Intrinsic' CanMEDS roles of collaborator, communicator, manager, health advocate, scholar, and professional. This course has two main components: 'Process' component and the 'Final Portfolio Submission' component. In addition, Professionalism forms will be completed twice through the year. The 'Process' component of the course consists of one large-group introductory session, and seven mandatory small-group meetings throughout the academic year. Students will meet in small groups of up to seven or eight, with one resident (Junior Academy Scholar) and one faculty member (Academy Scholar) who will provide support with reflecting on experiences in the clinical setting, and the resulting effects these have on professional development. Each student’s final year three portfolio contains six sections, each one a reflection centered on one of the CanMEDS roles discussed. 

Psychiatry (PSS 310Y)

The six-week Psychiatry course begins with centralized teaching sessions that occur during the first three days. The clinical experience takes place in a variety of settings including inpatient units, psychotherapy clinics, ambulatory clinics, consultation liaison teams, and emergency settings. An integral component of the course is interviewing patients and/or standardized patients with anxiety, mood, psychosis, cognitive, and substance disorders with focus on symptomatology, diagnosis, and basic treatment principles. All clerks will have exposure to psychiatric emergencies mostly by taking night and weekend on-call not exceeding one in five, until 11 p.m. Clinical experience with children and families take place during two half-days in a child psychiatry setting under the direct supervision of a child psychiatrist. Seminars are held weekly at each hospital site and include topics such as interviewing skills and dealing with challenging personality styles.

Surgery (SRG 310Y)

This eight-week course commences with a one-week centralized program, “Prelude to Surgery,” which provides an orientation and introduction to important surgical topics. The students then rotate through two three-week sub-rotations: one sub-rotation in General Surgery and the other sub-rotation in one of the other surgery specialties. The last week will comprise of attending the Central Seminars, debriefing and exam preparation sessions, and other administrative tasks. Students have input into their choice of sub-rotation specialties and are assigned to a surgeon preceptor for each of their sub-rotations. Students contribute to the admissions and daily patient care and attend the operating room and the clinic /office of their preceptor or team. The on-call schedule is one night in four. Call must be taken in General Surgery, Orthopaedics, or Neurosurgery. This provides them the opportunity to see patients in the ER as well as taking call to the ward and OR, where appropriate.


Integrated Objective Structured Clinical Examination (OSCE) (OSC 310Y / OSC 410Y)

The integrated OSCE (iOSCE) is a transcripted course which includes an Interim iOSCE and Final iOSCE. The Interim iOSCE is held after first 24 weeks of third year and includes six stations linked to the curriculum covered in the first 24 weeks of the year. The Final iOSCE is held after 48 weeks of third year and includes ten stations – six of which are linked to the 24 weeks of curriculum that a student has just completed, and four integrated stations reflecting the entire third-year curriculum.

Fourth year

Electives (ELV 410Y)

The 15-week electives course occurs between September and December of fourth year. Students complete a minimum of 13 weeks of electives while two weeks are designated as vacation. The electives program provides students with the opportunity to explore career possibilities, to gain experience in aspects of medicine beyond the core curriculum, and to study subjects in greater depth. Knowledge, skills, and attitudes are further developed in a clinical context selected by students. Fourth year students are expected to set up their individualized elective experiences at the University of Toronto or at other recognized sites of practice, such as other medical schools across Canada as well as in northern and non-urban practices. You may also undertake global health electives in accordance with University of Toronto regulations.

Integrated OSCE (OSC 310Y / OSC 410Y)

The integrated OSCE is a transcripted course which includes an Interim iOSCE and Final iOSCE. The Interim iOSCE is held after first 24 weeks of third year and includes six stations linked to the curriculum covered in the first 24 weeks of the year. The Final iOSCE is held after 48 weeks of thrid year and includes ten stations – six of which are linked to the 24 weeks of curriculum that a student has just completed, and four integrated stations reflecting the entire third-year curriculum. You are oriented to the iOSCE at a town hall session by both the Chief Examiner and staff from the Standardized Patient Program.

Portfolio (PFL 410Y)

UME Portfolio in fourth year takes the introductory experiences of the third-year Portfolio Course and builds upon them to help students assess, discuss, and reflect on their overall evolution into newly graduating physicians. This course has two main components: the 'Process' component and the 'Final Portfolio Submission' component. The 'Process' component of the course consists of three mandatory small group meetings. As in the previous year, students meet in small groups of up to seven or eight, with one resident (Junior Academy Scholar) and one faculty member (Academy Scholar) to support them in reflecting on their experiences in the clinical setting, and the resulting effects on their professional development. Students will continue with the same group of peers that they worked with in third year, and for the most part will work with the same Academy Scholars. Each student’s final portfolio submission will contain three sections, each one a reflection centered on one of the meeting themes discussed.  The themes discussed are: "Where I have been" "The Physician I aspire to be" and "Where I am now".

Transition to Residency (TTR 410Y)

The 14-week Transition to Residency (TTR) course occurs during the final 14 weeks of the MD Program, and is designed to bring together and build upon many of the concepts students have learned about functioning as doctors. The course has two main themes: understanding the health care needs individual members of diverse groups within the Canadian population, and learning to use the health care system to meet those needs. The course is comprised of two 'campus weeks' which contain both independent and classroom based learning activities, three selectives clinical placements over nine weeks, and the fusion period which brings the students back together for review of previously learned clinical material in preparation for the Medical Council of Canada Qualifying Examination (MCCQE) Part 1.



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