Clerkship

Organisation of fourth year

• 4 weeks of mandatory selectives (two weeks in Internal Medicine and two weeks of Surgery)
• 18 weeks of electives*
• 2 mandatory formative exams (September & January)
• Portfolio on core competencies (2 meetings, one post per meeting, and a final ePortfolio)
• 4 weeks of Back to basics sessions

You will have 2 weeks of vacation for the winter break and 3 weeks reserved for residency interviews.

*Any student who has not done the mandatory 4 consecutive weeks of community placement during 3^rd year will be required to complete it during 4^th year.

Schedule

The 4^th year schedule is divided into six groups and you will be assigned to one of these groups via a lottery in early January.

The difference between the six groups is the period of dates for the mandatory selective. Each group will have the same pathway from September to mid-November (first 10 weeks of electives), then the pathway will change depending on the groups.

Your group choice must be based on your academic needs. For example, if you plan to attend a conference, you must ensure it is not during your mandatory selective as 100% attendance is required for the selective.

Note that the admission interviews will be held from February to March (with a training in January), therefore you must be assigned to group 5 or group 6 if you want to participate.

See course schedule here.

Mandatory Selectives in Internal Medicine and Surgery

You will be required to do a 2-week rotation in an Internal Medicine subspecialty and a 2-week rotation in a Surgery subspecialty at The Ottawa Hospital.

After finalizing the 4^th year groups and schedule, each student will be asked, through a lottery, to pick their choices of Internal Medicine and of Surgery subspecialties within a certain time frame.

Once these have been assigned and the internal medicine rotation schedule has been finalized, any spots that have not been filled will be made available for elective placements.

For further information, please contact the coordinator for the appropriate Selective.

Internal Medicine Selective

Once you are assigned to a group, the second lottery will allow you to rank the following subspecialties for the mandatory Selective in Internal Medicine:

Surgery Selective

Once you are assigned to a group, the second lottery will allow you to rank the following subspecialties for the mandatory Selective in Surgery:

The duration of your Surgery Selective is of 2 weeks for the majority except for oncology which is 1 week.

ONCOLOGY: The oncology unit offers you to do one week in one of their subspecialties and a second week in another subspecialty. Therefore if you choose an oncology subspecialty, you must automatically choose another subspecialty for one week.

* PLASTIC: You cannot choose this subspecialty if you have done it during your 3^rd year or if you are planning or have booked a 4^th year elective at TOH. A student is allowed to have only one (1) placement in Plastic (TOH) during their clerkship. If you select plastic, but are not eligible, you will be placed in another specialty without consultation.

In 4^th year of medical school, you will have more freedom to adapt your electives to meet your specific needs with regards to career choices.

The 18 weeks of electives in 4^th year is placement time that should be used to learn more about the discipline that may be selected for residency or to enhance competencies in a clinical field which was not sufficiently explored in the 3^rd year. A majority of students use their elective time to explore possible residency programs or to make themselves known to the programs they are interested in.

One of the key elements to admission in a residency program is to have completed electives in the selected discipline. It is very unlikely that a student will be admitted to a residency program in a discipline for which they have not demonstrated an interest and commitment by doing 1 or 2 electives in the given specialty. However, it is not necessary to complete an elective in every residency program in the country to be matched in that discipline. You can refer to the description of the programs on the CaRMS website for more information on what programs are looking for in their candidates. Electives in other areas including research are encouraged.

Electives usually last 2 to 4 weeks (one week is also accepted) and every student has the responsibility to organize their own placements. It is recommended to not wait too long as places are sometimes quite scarce and greatly coveted by many students from across the country.

You may undertake electives at any Canadian, North American LCME/CACMS accredited medical school, Distributed Medical Education (DME) provincial network, or approved community setting. You may also choose to complete international electives.

It is recommended to wisely use the first 10 weeks of electives to gain exposure to potential programs however all weeks before the December vacation are also very important for networking. While it is important to use this elective time to explore residency training programs, every effort should be made to diversify the electives and balance clinical strengths.

See the following resources to help in planning your career:

Career planning: Students Affairs

Residency programs:  Canadian Resident Matching Service (CaRMS) 

General conditions

It is expected that an elective will be comprised of 35 hours per week.

You are required to complete a total of 18 weeks before the end of 4^th year. The only electives that will be counted toward the 18-week requirement are those that have been approved and entered in your Clinical Placement account and for which evaluations confirming successful completion have been received.

These electives can be either clinical or non-clinical in nature, however you are not allowed to do more than four (4) weeks of non-clinical electives throughout 4^th year.

Your supervisor must be a practicing physician, not a resident.

It is expected that you will be in Canada and the continental USA on CaRMS Match Day. That being said, international electives are not permitted during that period. This is to ensure the students can be easily contacted and are able to urgently return to Ottawa should the need arise. Our concern lies in the event of an "unmatch" as timelines involved in this process can require less than 24 hours turnaround.

Conflict of interest in clinical placements

Students cannot be supervised in any clinical placements (i.e., core rotation, selective or elective) by a member of their immediate family, extended family including in-laws treating physician or others close to them who could compromise the objectivity of the student's assessment.

In addition, students are not permitted to do clinical placements in the clinic of his or her treating physician. Students must immediately notify the Medical Education Office or Rotation Coordinators to request reassignment if their assigned placement is in violation of this policy. If a physician has treated a student in the past, they should make efforts to avoid any future situation that would put them in a position of evaluating that student.

Students are not permitted to participate in clinical placements at the University of Ottawa Health Services if they have been treated at that Service in the past.

Cancellations

Please select your elective carefully as switching or cancelling electives once they are booked is discouraged. If it is absolutely necessary to cancel an elective, you must notify the school's Electives Coordinator, department coordinator and/or preceptor in writing or through the AFMC Student Portal at least 6 to 8 weeks (depending on the policy) before the start of the elective. Failure to adhere to this national policy will be considered a breach of professionalism and may be reported to the Director of Electives and the Assistant Dean - Academic Affairs, Undergraduate Medical Education.

National 8-week notification policy

It is your responsibility to keep track of the status of your submitted applications. Just as you are required to provide a cancellation notice at least 6 to 8 weeks before an elective start date, all Canadian medical schools are also committed to working on visiting elective applications up to EIGHT (8) WEEKS prior to an elective start date. If schools cannot place you by the 8-week mark, they will notify you so that you are still able to secure an elective at your home school for that elective period.

When planning your electives, make sure to follow the appropriate process for the service you are applying to as these can vary by school and location. It is best practice to communicate with all contacts via your uOttawa student email so that they can clearly identify you as a uOttawa student.

Electives in Ottawa

You can browse the Elective Opportunities section of the Electives website to find all the opportunities offered to uOttawa students by the departments in Ottawa. It provides a description of the elective as well as information on how to request an elective. Make sure to get a written confirmation of the elective. There are no fees related to these requests and they are made directly with the coordinators. See the Contacts section for the complete list of department coordinators.

Note: Clinical and hospital settings in Hull and Gatineau (Outaouais region) are affiliated with McGill. You must therefore apply through McGill.

Electives at other Canadian Universities

The AFMC Student Portal is now the principal tool to set up clinical electives at Canadian universities. You will be required to pay a one-time fee to create your profile and will then be able to apply to elective opportunities offered by each school at their listed fees.

Before applying for an elective, please keep in mind the following:

• Each school has its own application guidelines. It is crucial you carefully review the guidelines listed on the Institution Profile page for the school you are interested in. Look at application fees, pre-requisites, application timelines, special rules (ex. being able to submit only 1 application or complete 1 elective at a certain school per year; coordinating electives outside the Portal before officially applying...), etc.
• You may be required to complete the IELTS-Academic exam for language proficiency (for electives as well as CaRMS). You should verify this early on and make the appropriate arrangements in advance. Test results are valid for 2 years.

Once you submit an application on the AFMC Student Portal, the uOttawa Electives Coordinator will receive a notification to complete the Home School Verification to confirm your academic status. Your application will then move on to the next step for processing.

For detailed information on how to use the AFMC Student Portal, the AFMC has posted Help Documents for students (under Quick Links at the bottom of the Portal’s website). You can also contact their help desk if needed.

Other elective resources

There are numerous options available to you when planning your electives. Other great resources can include:

• Rural Canadian Electives
• International Electives

You are not limited to clinical electives in 4^th year. There are a variety of non-clinical electives offered during the year, including research electives which are a great way to get additional exposure to a specialty:

• Non-Clinical Electives

In order to meet the accreditation requirements, all electives must be pre-approved by the Faculty of Medicine, Undergraduate Medical Education Office (Liaison Officer, Year 4) in order to be eligible and credited.

You must request an approval for all your electives through your Clinical Placement account. All requests must be made at least one month prior the start of any elective. This will be monitored regularly.

If you do not have a pre-approved elective in your Clinical Placement account 2 weeks prior to a given date, it will be brought to the attention of the Clerkship Director. 

Any changes to your registered approved electives must be done through your Clinical Placement account by entering a new request. Then you must delete the entry that is no longer valid.

IMPORTANT: An elective cannot be started if it has not been pre-approved and will not be credited if you do not comply with this procedure. If you complete an elective without having it pre-approved, it will potentially be considered a professionalism issue and will be brought to the attention of the Clerkship Director. 

How to request approval for your electives

To request approval for your electives, please follow these steps:

1. Plan your elective.
2. Go to the Student Tools application.
3. Enter your username and password (the same as the ones used to access your ONE45 account).
4. Open your file by choosing "Clinical Placement".
5. Choose: "Request approval for an elective".
6. Make sure to complete all sections of the form and then choose "Submit".
7. Once the Medical Education Office has approved your elective (in a delay of 48-72 hours), your Clinical Placement account will automatically be updated.

NOTE:

For electives in the City of Ottawa: Choose the preceptor name from the dropdown menu.

• If the preceptor does not appear in the dropdown menu, select the option “Preceptor does not appear in list” and the Electives Coordinator will contact you to get the information too add the preceptor to the menu.
• If no supervisor has been assigned to you at the moment you receive a confirmation, select the option “Elective confirmed by Department Coordinator”. At the end of the elective, update the elective with the preceptor who supervised you.

For electives outside the City of Ottawa: Enter the preceptor's name and email in the free-text boxes that appear.

• If no supervisor has been assigned to you at the moment you receive a confirmation, you must enter the name of the coordinator who confirmed the elective. You will be able to modify this entry at the end of your elective. Requests with TBD, TBA, Multiple preceptors, do not know, etc., will not be approved.

All clinical electives have been categorized into groupings according to the CaRMS’ list of disciplines*. When registering your electives in your Clinical Placement account, you will need to tag your elective to the appropriate grouping.

In 4^th year you must cover a minimum of 3 groupings, by doing at least 2 weeks in each grouping. A maximum of 10 weeks of clinical electives is allowed in the same grouping. Therefore a student cannot do more than 10 weeks in the same specialty.

Non-clinical electives do not count towards groupings.

*A grouping is created from the CaRMS’ list of disciplines:

In general agrouping is determined by the CaRMS entry point to get into a discipline (or the main specialty of a preceptor). However there might be exceptions. For example:

• If a student is on elective with a family physician doing only emergency medicine, it will count as the Emergency Medicine grouping.
• If a student is following a family physician and doing both emergency medicine and also seeing patients at the clinic, then it will count as the Family Medicine grouping.

After week #10 (between November and March), students must do a minimum of 4 weeks of electives (which do not have to be consecutive) outside The Ottawa Hospital (TOH).

Any student who has not done the mandatory 4 consecutive weeks of community placement during 3^rd year must do it in 4^th year.

Please visit the Distributed Medical Education (DME) website for more information or contact them at dme@uOttawa.ca.

All placements (selective & elective) must be validated with an evaluation.

We must receive one evaluation per placement.

Elective evaluations must be completed by practicing physician, not a resident.

At the end of 4^th year (end of March), your file will be considered as complete only if all evaluations have been received and are successfully passed.

You must succeed in all your placements to be eligible to the M.D. degree.

If you fail a placement, remediation will be mandated after meeting with the clerkship director.

You must always keep a copy of your evaluations for your personal records.

Elective Evaluations

A few days before the end of each elective, you must return to your Clinical Placement account to indicate that your elective has been completed. Then you must complete 3 mandatory steps:

• Evaluation of preceptor by student;
• Evaluation of elective experience by student;
• Evaluation of student by preceptor – Send evaluation to preceptor

Each student must comply with the deadlines provided.

For any problems with elective placements, please inform the Liaison Officer, Year 4 at 613-562-5800 ext. 3808 or by email at medyear4@uottawa.ca or the Electives Coordinator at 613-562-5800, ext. 8552 or by email at elective@uottawa.ca.

Selective Evaluations

Evaluation of mandatory Selectives will be done through one45.

The Selective coordinators will send you the evaluation forms in your One45 To Do page.

1. You will select your preceptor and send the evaluation. Only one preceptor is responsible to complete your evaluation even if you have worked with multiple preceptors.
2. You must evaluate each preceptor and resident you have worked with even if it is only for a half day.

Registered students at the University of Ottawa are covered by the University’s Commercial General Liability Insurance with a limit per occurrence in excess of C$5.000,000 inclusive for medical malpractice, bodily injury, personal injury and property damage as described in detail in the policy while on clinical placements during the academic year, whether in Canada or abroad.

Note that the University of Ottawa’s Commercial General Liability insurance policy only applies to placements when students are receiving academic credit. Therefore, students are only covered by our insurance when they are successfully completing the required 18 weeks of Electives and 4 weeks of Selectives. If you voluntarily undertake additional placements, you will not be covered by the University’s insurance for these additional weeks and will place yourself, the receiving institution and the physician you are working with at risk. You will not receive academic credit for those weeks.

4th year is based on your individual needs. Learn to recognize them and take advantage of the various options available to you. If there is a major problem with your schedule, we are available to help you out. Some requests for changes may be approved, depending on availability.