MEDICAL EDUCATION The Longitudinal Integrated Clerkship

Longitudinal integrated clerkships (LICs) are one of the first major efforts to restructure core clinical training for medical students. Since the time of the Flexner Report (which will be 100 years old next year), core clinical training for medical students has occurred primarily on inpatient teams in block rotations. The rotations are intended to allow students to work closely with a team of faculty and residents, participate in the care of hospitalized patients, and receive feedback and mentoring from team members who observe their performance over several weeks. Students working with teams during the clerkship years are expected to develop their professional identity as physicians, adopting professional and ethical standards such as honesty, integrity, accountability, and openness and responsiveness to feedback. They are trained to communicate effectively with both patients and colleagues. As health care delivery has changed over the last 20 years, this traditional structure of clinical training no longer functions as intended. Students rarely spend more than a few days with the same residents, attending physicians, and patients. Shortened rotations, increasing complexity of inpatient illness, and resident duty-hou