Internal Medicine Undergraduate Education

Floor teams (3rd and 4th year students)

The internal medicine clerkship is the core experience for the acquisition of the knowledge, skills, attitudes and behaviors required to care for adult patients in the hospital and outpatient settings. The behaviors acquired during this rotation form the foundation for growth in both the medical and surgical specialties. These are important aspects of the skills of physicians in all disciplines of medicine.

The purpose of the core clerkship in internal medicine is to provide students with the clinical and didactic experiences that will enable them to diagnose and manage patients with the disease processes commonly seen in general internal medicine. It is during this rotation that the information obtained during the basic science years becomes integrated into day-to-day clinical practice. It is the desire of the Department of Medicine to expose the student to the variety of venues in which internal medicine and its subspecialties are practiced, and the range of opportunities available to those who choose careers in internal medicine.

Student role

  • Evaluate and follow patients assigned by the supervising resident or attending physician.
  • Function as a member of the team.
  • Seek information and develop in-depth knowledge of the pathophysiology of the clinical disorders seen.
  • Develop complete history and physical examination skills.
  • Integrate history and physical examination data to arrive at a thoughtful and complete differential diagnosis and plan.
  • Present patients in a cohesive and thorough manner.
  • Model the behaviors and values necessary to conduct the evaluation and care of the patient with respect, compassion and integrity.
  • Acquire an understanding of the cost of various studies.
  • Attend and participate in the formal educational programs provided.

Student responsibilities: clinician, learner, teacher

All physicians, regardless of their level of experience, are both learners and teachers. As one progresses through the educational system to independent practice, the relative levels of responsibilities for each of the components of physician activities grow.

Clinician Role:

  • Document all history and physical examinations and progress notes in the medical record.
  • Synthesize the clinical information in a weighted differential diagnosis.
  • Present the patient to the team in a coordinated and cohesive manner.
  • Begin to appreciate opportunities for prevention and early detection of disease.

Learner Role:

  • Learn from patients by listening and close observation.
  • Self directed learning: read about patients and disease states to reinforce and add to the student’s knowledge base.
  • Learn from others: discussion of cases, literature, lectures and other information sources. In addition to residents and attendings, nurses, social workers, respiratory therapists and many others can add significantly to one’s knowledge base and professional development.


  • Share information with other students, faculty, and other personnel.
  • Participate actively in teaching rounds, conferences, work rounds and other venues.
  • Discuss patient care issues with them and when appropriate, their families, on an ongoing basis in a sensitive and caring manner.
  • Teach oneself by self assessment, reading, and constant questioning.

Rotation responsibilities:

  • Attend medical morning report daily (mandatory for 4th year students and strongly recommended for 3rd year students).
  • Make daily rounds on assigned patients and write a daily progress note. A new patient should have the history and physical examination placed in the appropriate chart section.
  • Take call as assigned by your team overnight or until the night float team arrives for their evening shift.
  • Participate actively in RRTs (rapid response teams) and codes as requested by your team/resident.
  • Attend Grand Rounds weekly 8–9 a.m. in the John H. Ammon Medical Education Center.
Director Matthew Burday, D.O. (director, Medical Student Programs, Dept. of Medicine and 3rd year clerkship); Cheryl Jackson, M.D., FACP (4th year program)
Student Coordinator Paula Barnes: 302-733-6059,
Location Christiana Hospital (floor services)
Duration Subspecialties for 4th year students; 4 weeks for students in the clinical campus.

Internal medicine subspecialty

Two students MICU-Christiana Hospital; One student in the CCU – 4th year only.

One student for each of the other subspecialties (3rd year Jefferson Clinical Campus and 4th year students.)

  • Med/Peds.
  • Hematology and Oncology.
  • Pulmonary.
  • Rheumatology.
  • GI.
  • Infectious Disease.
  • Endocrinology.
  • Nephrology.
  • Cardiology.
  • Neurology.
Director Matthew Burday, D.O. (director, Medical Student Programs, Dept. of Medicine and 3rd year clerkship); Cheryl Jackson, M.D., FACP (4th year program)
Student Coordinator Paula Barnes: 302-733-6059,
Location Christiana Hospital, Wilmington Hospital and outpatient offices, depending on the rotation.
Duration Four weeks for subspecialties for 4th year students and 3rd year clinical campus students.

Combined emergency medicine / internal medicine elective (4th year)

Christiana Care Health System, Departments of Internal Medicine and Emergency Medicine offer a Combined Emergency Medicine / Internal Medicine elective rotation.

This fourth-year elective provides students with the opportunity to immerse themselves in a true combined EM/IM clinical experience. It is primarily an emergency medicine elective (please see details for the emergency medicine fourth year elective), that also gives exposure to internal medicine in both the outpatient and inpatient settings. Each week of the four week rotation is divided between both Christiana and Wilmington hospitals, with at least 10 shifts scheduled in the emergency departments. This amount of time allows students to get full emergency department standardized evaluations, which can be used for EM as well as EM/IM residency applications. Additionally, students are paired with upper level EM/IM residents to work at least three to four days on one of the inpatient units (MICU or medicine floor), and at least two half days in the outpatient setting. The EM/IM clinic at Wilmington hospital provides a unique perspective on caring for medically complex patients in an underserved urban setting. While the overall internal medicine exposure is not to the level of a full sub-internship, students definitely get a great feel for what it is like to be a combined EM/IM resident at Christiana Care Health System. There is daily interaction with EM/IM trained residents and faculty, as well as ample time spent with the EM/IM program director for input and feedback.

The Christiana Care EM/IM residency is one of the most long-standing and well established in the country. We have been graduating residents since 1996, and have a comprehensive and cohesive curriculum combining pathology, teaching, mentorship, and exceptional clinical skill. This rotation, the first of its kind in the country, has been fine-tuned over the last seven years, and is ideal for medical students interested in pursuing a combined residency in internal and emergency medicine.

A car is recommended for the rotation. Housing during the rotation may be available, if the student meets criteria established by Christiana Care.

Director Jason Nace, M.D., Assistant Program Director, EM/IM Residency Program
Student Coordinator Sherrill Mullenix: 302-733-1919,
Location Each week of the four week rotation is divided between Christiana and Wilmington hospitals, with the majority of the time spent in the emergency department, but also exposure to both inpatient and outpatient internal medicine.
Duration Four week elective for 4th year medical students.