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1. Purpose

1.1. To state elective expectations regarding approved sites, duration, clerk assessment forms and elective evaluations, the appropriate procedure for elective approval and change/cancellation requests, immunization requirements, as well as malpractice and personal insurance.

1.2. To outline the importance of additional electives with the understanding that clerks need vacation time to support their mental, physical, and spiritual wellness.

1.3. To ensure compliance with Accreditation Standards:

- Standard 6.5a: There are opportunities for elective experiences in the medical curriculum particularly in the later years of the educational program that permit medical clerks to gain exposure to and deepen their understanding of medical specialties reflecting their career interests and to purse their individual academic interests.

- Standard 6.5b: The medical school has policies or practices that encourage medical clerks to use electives to pursue a broad range of interests in addition to their chosen specialty.

2. Definitions

UGME: Undergraduate Medical Education.

CACMS: The Committee on Accreditation of Canadian Medical Schools (CACMS) was founded to act as the reliable authority for the accreditation of programs of medical education leading to the MD degree in Canada. The CACMS accredits complete and independent medical schools whose students are geographically located in Canada for their education, and which are offered by universities that are chartered and operated in Canada. (Reference: https://cacms-cafmc.ca/about-cacms)

Summative assessment: The quantitative assessment used to measure students’ understanding and theoretical application skills after a predetermined period of instruction of a section, chapter, unit, module, or course.

Formative assessment: The assessment used formally and informally to monitor as well as support students’ learning progress during instruction of a course/rotation. It typically involves qualitative or narrative feedback (rather than quantitative scores) to focus on specific content details and aspects of performance.

CaRMS: Canadian Resident Matching Service.

AFMC: Association of Faculties of Medicine of Canada.

3. Scope

This policy applies to U of S College of Medicine undergraduate students in the graduating class of 2018 and onward.

4. Policy Guidelines

Clerks are responsible for arranging their electives. Electives may be completed at:

- Any CACMS accredited medical school and/or LCME accredited North American medical school.

- Approved international sites.

- Other sites as approved by the UGME Year Chair.

Clerks will not be granted credit for an elective supervised by a member of their immediate or extended family as well as anyone with whom they have a personal relationship with or have another conflict of interest. Additionally, clerks will not be granted credit for an elective with any physician providing care to them, or physicians with the Office of Student Affairs. https://medicine.usask.ca/policies/conflict-of-interest.php

Clerks are strongly encouraged to meet with a Career Advisor prior to their electives application to develop a personalized learning plan for their elective year. The electives worksheet will then be submitted to the UGME office ugme.electives@usask.ca and sent to the appropriate Year Chair/ Site Coordinator for approval, recognizing that changes may occur due to scheduling.  Focus will be placed on the 12 weeks of electives prior to CaRMS.

All elective applications must be requested through the appropriate Department Coordinators. Electives cannot be scheduled directly with an individual preceptor or site as this impedes departmental scheduling and coordination of clerks. Clerks looking for a certain experience must include this request in their elective form or speak with the Department Coordinator. Before starting an elective, clerks must have approval from the Year Chair or Year Site Coordinator. Clerks must ensure pertinent information regarding each elective is current and accurate in One45, and are responsible for completing and submitting the elective summative assessment form as well as the elective evaluation.

All clerks must complete a minimum of 20 weeks of electives.  There are 22 weeks of electives scheduled, with the potential for 1 week (plus 1 week carry over from Year 3) of vacation time, and the potential for two weeks of remediation/independent learning time. Please note the maximum amount of time away from an elective in order to be considered complete is 3 days out of a 2-week elective.  One-week electives can be counted towards the total number, but no vacation time will be allowed during this week.

 An elective must be passed in order to receive credit.  If a student fails an elective for whatever reason, they may be required to remediate, even if they have met the 20 week minimum. Most electives are a minimum of two weeks in duration.  Typically, a maximum of 6 weeks will be allowed.  Electives start on Monday (Tuesday in the case of statutory holidays) and end on Friday.  Weekends are for travel time.  It is recommended that Clerks choose to participate in electives in Saskatchewan during the CaRMS match results to facilitate working on the second iteration and accessing the support to do so.

5. Procedures

5.1 Electives in Departments at U of S Sites

Clerks must submit the in-province (Internal) elective application forms to the Department Coordinator for approval at least 1 month prior to the start date of the proposed elective through the Sharepoint site. In-province elective applications can be submitted up to 26 weeks in advance of the elective start date. Refer to the elective course syllabus for detailed timeline information. The application form is available online with a valid NSID and password and can be accessed at: https://share.usask.ca/medicine/ugme/electives/SitePages/Home.aspx

Clerks must review the elective objectives and develop individual objectives that apply in conjunction with their elective supervisor.

The Department Coordinator, with their administrative support, will submit their approval or rejection of the requested elective through the online SharePoint form system. The Year Chair/Site Coordinator will be notified at this point if the elective is approved. Clerks will be notified at this point if the elective application is rejected. The Year Chair/Site Coordinator will give final approval or rejection of the elective application and clerks will be notified of either status. All electives must receive approval from the appropriate departments and Year Chair/Site Coordinator to be considered official. Students are then responsible for either accepting or cancelling the approved elective. Site specific UGME staff will ensure entry of elective information into One45. Once submitted, the elective will be considered finalized.

Preceptors will be sent a Summative Assessment form from the UGME Office by the last week of the elective. The clerk is responsible for ensuring an elective Summative Assessment form is completed by the preceptor, as well as submitted to and received by the UGME Office. Clerks will be notified within 2 weeks of the end date of the elective if a Summative Assessment form has not been received. Clerks must ensure the UGME Office receives their final Summative Assessment form from the appropriate preceptor within 6 weeks of the elective end date. Failure to do so will be considered a failed elective and no credit will be granted. The clerk is responsible for completing the appropriate elective evaluation within 4 weeks of the elective end date and submitting it to the UGME Office.

5.2 Electives in Other Canadian Provinces

Clerks must apply through the AFMC portal for electives at all other Canadian medical schools. Most application timelines are 26 weeks prior to the start date of the elective. Refer to the AFMC portal for official timelines: https://www.afmcstudentportal.ca/.

- AFMC Clerk Registration Information

- AFMC Clerk Application Process

- AFMC Help Documents

For confirmed electives to be added to One45, the clerk must email the official confirmation from the AFMC Portal to: ugme.electives@usask.ca. In order to be approved, the student must include a preceptor name and email with the AFMC confirmation. Once submitted, the elective will be considered finalized.

The clerk is responsible for ensuring an elective Summative Assessment form is completed by the preceptor, as well as submitted to and received by the UGME Office. Clerks can send the Summative Assessment Form through One45 by setting up a temporary account through the Sharepoint site: https://share.usask.ca/medicine/ugme/electives/Lists/Outofprovince%20Elective%20Preceptors/NewForm.aspx. Clerks will be notified within 2 weeks of the end date of the elective if a Summative Assessment form has not been received. Clerks must ensure the UGME Office receives their final Summative Assessment form from the appropriate preceptor within 6 weeks of the elective end date. Failure to do so will be considered a failed elective and no credit will be granted. The clerk is responsible for completing the appropriate elective evaluation within 2 weeks of the elective end date and submitting it to the UGME Office.

For electives 4 weeks or longer, it is strong recommended that the clerk requests their preceptor to provide mid-point formative feedback and complete a Formative Assessment form; however, a Formative Assessment form is not required to be submitted to the UGME Office.

5.3 International Electives

The minimum elective duration is 2 weeks with a maximum of 8 weeks. Clerks must submit the international electives application form to the Year Chair for approval at least 6 months before the start date of the proposed elective. The application can be found on the Sharepoint site: https://share.usask.ca/medicine/ugme/electives/_layouts/15/start.aspx#/SitePages/Home.aspx  A closer application time may be considered if the DSA pre-departure orientation from the Division of Social Accountability has already been completed; however, a minimum of 2 months prior to the start date of the elective is required. Clerks must meet with the Global Health Manager, Division of Social Accountability and participate in the DSA pre-departure orientation course, if they have not already done so. Participation is tracked. Please note that if the pre-departure orientation from the Division of Social Accountability has not been completed, this must be complete prior to the elective being approved.

Clerks must register with the International Student and Study Abroad Center (ISSAC). ISSAC requires all students to complete the Travel Safety Plan as well as provide emergency contact information and confirmation of insurance. If the elective is deemed to be in a high-risk area as per ISSAC criteria, the Year Chair (or designate) will be notified and the elective will be denied. Appeals of denied international electives can be made to the Dean of Medicine with a carbon copy (cc) to the Manager, Undergraduate Medical Education.

The clerk is responsible for ensuring the UGME Office has received confirmation of registration with the ISSAC office as well as the Division of Social Accountability. Once confirmations and the international elective form are received, the elective will be considered for final approval. The Year Chair will give final approval or rejection of the elective application and clerks will be notified of either status. For approved electives to be added to One45, the clerk must email the official confirmation of DSA orientation completion from the ISSAC to: ugme.electives@usask.ca. Once submitted, the elective will be considered finalized.

Clerks may be required to purchase additional malpractice insurance depending on the elective location (Refer to article 15. Insurance for more details). Extra funding opportunities may exist through the Division of Social Accountability in the form of research and travel awards. Please contact the Division of Social Accountability Office for inquires and/or additional information.

The clerk is responsible for ensuring an elective Summative Assessment form is completed by the International Elective preceptor and submitted to the UGME Office. Clerks will be notified within 2 weeks of the end date of the elective if a Summative Assessment form has not been received. It is their responsibility to contact the preceptor and ensure the Summative Assessment form is completed. Clerks must ensure the UGME Office receives their final Summative Assessment form from the appropriate preceptor within 6 weeks of the elective end date. Failure to do so will be considered a failed elective and no credit will be granted. The clerk is responsible for completing the appropriate elective evaluation within 6 weeks of the elective end date and submitting it to the UGME Office.

For electives 4 weeks or longer, it is strong recommended that the clerk requests their preceptor to provide mid-point formative feedback and complete a Formative Assessment form; however, a Formative Assessment form is not required to be submitted to the UGME Office.

The clerk must participate in a post-elective debriefing with the Division of Social Accountability.

 This meeting will include feedback on the elective learning environment, overall learning experience, and any challenges faced. The clerk should notify the UGME upon their return from their elective. If the clerk requires further supports related to experiences during their elective, these will be facilitated through the Office of Students Affairs.

6. Diversity

As per a national agreement among 4-year M.D. programs, clerks must complete a minimum of 3 diversity electives, each a minimum of 2 weeks in length. This is defined as any discipline/specialty that is a direct entry into CaRMS, and must include 3 different general areas (e.g. Internal Medicine, Surgery, Anesthesia, Emergency Medicine, Pediatrics, Psychiatry, Family Medicine, PM&R, Pathology, Radiology, Nuclear Medicine, etc. ).  Elective diversity allows the clerk to experience a broader scope of medicine and may help with residency preparation.  

Please note the AFMC has changed the diversity requirements for the Class of 2021. Please see the AFMC website for updates.

7. Vacation

In Year 4, clerks are entitled to 3 weeks of vacation: 1 week of their choice and 2 weeks during the December break. To ensure proper work-life balance and maintenance of overall wellness, it is strongly encouraged that all clerks utilize the entirety of their allotted vacation time. Clerks may defer up to 1 week of vacation time from Year 3 in to Year 4.

Please note the maximum amount of time away from an elective in order to be considered complete is 3 days out of a 2-week elective.  One-week electives can be counted towards the total number, however they cannot be combined with a week of vacation and count as 2 weeks of electives.

Clerks are discouraged from taking electives during the holiday break in December due to potential supervision concerns, as many clinical learning sites have fewer staff and residents during this time. If a clerk proposes to undertake an elective during this time, the clerk must provide written documentation from their preceptor stating they will receive adequate supervision.

8. Additional (Early) Elective Time

Clerks can be considered for an additional 3 weeks of elective time during Year 3 (to a maximum of 25 weeks total of electives). The clerk must be in good academic standing as well as meeting expectations on all rotations to be considered and approved for additional elective time. The Year Chair must approve the extra elective time prior to beginning the elective application process. Clerks will not be approved, nor will receive credit, for more than 25 weeks of electives. Please note that even if an elective is completed in Year 3, all scheduled weeks of electives in Year 4 must still be completed (outside of vacation and education time).

9. Application Procedure for Additional (Early) Elective Time

The clerk must submit a written request to the Year Chair no later than 1 month prior to the start date of the elective. The request must include a description of the additional elective and rationale for why the additional elective time is needed. Additional elective time requested during the December break must be accompanied by correspondence from the proposed elective Department Coordinator indicating that there

will be adequate clinical supervision of the clerk. The clerk must also apply for and have vacation time approved prior to applying for elective.

The relevant Year Chair reviews additional elective requests. If the following criteria are met, the additional elective time will typically be approved:

- The clerk is in good academic standing;

- The request does not exceed the maximum 25 weeks of electives; and

- There is clear rationale for the additional elective time.

The Year Chair will communicate the application status to the clerk as soon as possible, but ideally within 2 weeks of the request submission. If a request is rejected, the clerk will be provided with an explanation. Application appeals can be submitted by the clerk to the Assistant Dean, Academic.

 

10. Cancellation Policy

Electives should be cancelled by the clerk at least 6 weeks prior to the start date of the elective. Failure to do so will result in a discussion regarding professionalism and possible documentation through a Professionalism Report/Discussion Form. Exceptional circumstances requiring an elective cancellation will be considered.

Clerks must notify the department where and when the elective was to take place. In addition, the UGME Office must be notified of the cancellation at: ugme.elective@usask.ca .

Please note that electives done at schools through the AFMC portal and international electives may have their own cancellation policy. Clerks will be expected to adhere to individual school’s guidelines and procedures.

11. Immunizations

All clerks must have received their mandatory immunizations OR shown proof of immunity prior to the start date of all electives. This is generally required during the application process. Any clerk not having met this requirement must report to the Occupational Health and Safety Office to update any missing immunizations. Immunization requirements are listed at: https://afmcstudentportal.ca/immunization  

For patient protection, all clerks (who do not have medical contradictions) are expected to be immunized for influenza. Clerks will be advised of any updates to provincial or regional public health policies for Saskatchewan electives.

Additional immunization requirements (i.e. international electives) will be at the student’s expense.

12. N95 Mask Fittings

All clerks are required to have a current and valid N95 mask fitting.

13. Police Information Check

External electives generally require a current criminal record and may require a vulnerable person’s check. These can be organized through the local Police Department. Please check the AFMC portal for individual school requirements. It is the student’s responsibility to provide the UGME and CPSS with any changes to the original Criminal Record Check submitted for clerkship.

14. Blood/Body Fluid Exposure

The Medical Student Exposure to Infectious and Environmental Hazards Policy and local health region/authority occupational health procedure can be accessed at: http://medicine.usask.ca/policies/medical-student-exposure-to-infectious-and-environmental-hazards.php 

15. Insurance

University of Saskatchewan clerks are covered under the U of S CURIE insurance policy for up to 25weeks of electives. This includes any contractual liability, professional and malpractice liability, cross liability, and tenant’s legal and employer’s liability arising out of their elective duties. Coverage applies to any electives taken within Canada.

Not all international electives are covered under CURIE (i.e. U.S. electives) and additional insurance will need to be purchased at the student’s expense. It is the student’s responsibility to ensure that insurance is purchased prior to the start date of the elective and to provide proof of insurance coverage to the UGME Office 2 weeks prior to the start date of the approved elective. If it is found that insurance is not in place, the elective will be cancelled and no credit received.

Please contact the UGME Office for any insurance inquiries at: ugme.electives@usask.ca

16. Distribution

This policy will be distributed to students as well as Department Coordinators and Site Directors.

17. College of Medicine Responsibilities

The Assistant Dean, Academic, is responsible for providing oversight to the overall administration of the Clerkship Electives Policy within the College of Medicine.

The Manager, Undergraduate Medical Education, with the assistance of the Undergraduate Medical Education Office, is responsible for the implementation, monitoring, maintenance, and evaluation of the Clerkship Elective Policy within the College of Medicine campus in Saskatoon, Saskatchewan.

18. Non-Compliance Responsibilities

Clerks not complying with the procedures outlined above will have their elective cancelled and no credit received. Instances or concerns of non-compliance with the U of S Clerkship Elective Policy should be brought to the attention of the Vice-Dean, Education or the Associate Dean, Undergraduate Medical Education, within the College of Medicine.

91. Contact

Sherry Pederson

Manager, UGME

Email: sherry.pederson@usask.ca

Phone: (306) 966-6142

Fax: (306) 966-2601

B526 Health Sciences Building, U of S

107 Wiggins Road

Saskatoon, SK S7N 5E5