Section 3: Clinical Education Requirements

The Registrar’s Office records clinic attendance, clinic hours and patient contacts for each student on the basis of the student timesheet, and hour and contact totals from the student’s clinical supervisors. At the end of each term, students receive individual Student Clinical Status Reports that track the student’s progress toward meeting the clinic hourly requirements outlined below. Clinic requirements are reviewed annually.

Students will track their own clinical hours via the student timesheet provided by the Registrar’s Office, which includes an up-to-date summary of patient contacts. The student timesheet constitutes the primary evidence regarding how many shifts were attended in a given rotation. The registrar provides clinic status and proficiency objective reports quarterly.

3.1 Summary of Clinical Hour Requirements

ND hour requirements ‒ Foundational Curriculum (matriculated before fall 2015)

RequirementTimingHours
Intro to Clinic1st year 12
Hydro/Massage One 48-hour rotation and 24 observation hours 72
Clinical Education2nd year spring 18
Secondary RotationsBegins summer before 3rd year, or fall of 3rd year (total of four graded rotations)
192
Primary RotationsBegins spring of the 3rd year (total of 15 graded rotations, plus 24 holiday hours)720
Senior Lab Post 4th year summer12
Community Education Any year of attendance24
Preceptorship HoursPreceptorship rotations can begin 2nd year240
Grand Rounds 3rd year60
Grand Rounds 4th year60

ND hour requirements ‒ Redesigned Curriculum (matriculated on or after fall 2015)

RequirementTimingHours
Observation I1st year 20
Observation II1st year20
Hydrotherapy/MassageOne 48-hour rotation during 2nd year 48
Secondary RotationsBegins summer before 4th year (at least three graded rotations)
180
Primary RotationsBegins spring of the 3rd year (at least 13 graded rotations)780
Preceptorship HoursCan begin winter of 1st year216

Note: There are 1,264 required clinical hours involving patient contact, performed in observation, hydrotherapy, secondary, primary and preceptorship roles. Additional clinical coursework is didactic in nature, providing orientation to and assessment of clinical activities, and does not include clinical patient contact. These activities include healthcare provider-level CPR (years 1 and 3), the Clinic Observation (year 1) and Introduction to Clinic (year 2) courses (which include HIPAA and OSHA training), and Grand Rounds (years 3 and 4).

DSOM and MSOM hour requirements

RequirementTimingHours
Intro to Clinic1st year 18
ObservationBegins fall of the 2nd year (total of three graded rotations)144
Clinical Case Presentation I-III3rd year72
Clinical Mentoring3rd year (total of six graded rotations)
288
Pre-Internship4th year48
Internship Case Presentation I-III4th year (total of nine graded rotations)72
Internship4th year (total of nine graded rotations), plus 24 hours holiday (non-graded)
432

There are a total of 1,098 clinical hours, of which 1,074 are required. The 24 holiday requirement hours are designed to maintain continuity of care for patients and may be used as make-up hours. 144 of the total hours are classroom hours spent in the refinement of clinical reasoning skills through the analysis of patient cases from the clinic.

MAc hour requirements

RequirementTimingHours
Intro to Clinic1st year 18
Observation2nd year (total of two graded rotations)96
Clinical Mentoring2nd year (one rotation)
48
Internship3rd year (total of 10 graded rotations), plus 24 hours holiday (non-graded)
480
Internship Case Presentation I-III3rd year72

Concurrent-degree students are required to do a total of 24 community education hours.

3.2 Description of Clinical Requirements

ND Requirements

The required ND Clinical Education curriculum is outlined in Section II, 1.4, with the hour breakdown listed in Section II, 3.1. It should be noted that as part of primary and secondary rotation requirements, ND students must work 144 summer hours and 24 holiday hours. The Registrar’s Office reserves the right to alter these requirements in conjunction with the program deans to ensure that sufficient student participation is maintained to operate the NUNM Health Centers.

CPR Requirements

Prior to beginning clinical rotations, ND students are required to complete healthcare provider-level CPR training, including the hands-on and written components. For ND students, training must be completed during the first year, prior to beginning hydrotherapy rotations in year 2.

CCM Requirements

Introduction to Clinic and Clinical Observation I & II

For CCM students, these courses provide an overview of clinical education requirements. They are designed as an orientation to duties and responsibilities for clinic rotations.

CCM students are introduced to the fundamentals of being an observer in the CCM clinics. Topics include HIPAA compliance, clinic policies and procedures, hygienic standards including Clean Needle Technique, charting protocols, patient confidentiality and multicultural awareness. Students take this course in the spring quarter of the first year of their program.

Summer and Holiday Internship

Each DSOM and MSOM intern is required to work 144 summer hours and 24 holiday hours. Each MAc intern is required to work 96 summer hours and 24 holiday hours. The Registrar’s Office reserves the right to alter these requirements in conjunction with the program deans to ensure that sufficient student participation is maintained to operate the NUNM Health Centers.

CCM Requirements

The required CCM Clinical Education curriculum is outlined in Section II, 1.4, with the hour breakdown listed in Section II, 3.1. It should be noted that as part of the internship requirement, MSOM and DSOM students must work 144 summer hours and 24 holiday hours. MAc students must work 96 summer hours and 24 holiday hours. The Registrar’s Office reserves the right to alter these requirements in conjunction with the program deans to ensure that sufficient student participation is maintained to operate the NUNM Health Centers.

CPR Requirements

Prior to beginning clinical rotations, CCM students are required to complete healthcare provider-level CPR training, including the hands-on and written components. For CCM students, this applies to observation rotations.

DSOM and MSOM Requirements

Clinical Case Presentation I-III

Students apply their didactic learning to clinical scenarios through case-based discussion and presentation.

Internship Case Presentation I-III

Students present their clinic cases to fellow interns and a faculty supervisor for discussion and feedback.

MAc Requirements

Internship Case Presentation I-III

Students present their clinic cases to fellow interns and a faculty supervisor for discussion and feedback.

3.3 Patient Contact Requirements

Each ND student must participate in a minimum of 510 patient visits at NUNM Health Centers or at an approved, affiliated community clinic. Of the 510 visits, 225 visits must be those for which the student serves as the primary. The remainder of each student’s patient contacts must be obtained at the clinic, at one of NUNM’s other approved clinical training programs, or on a preapproved preceptor rotation.

Each DSOM and MSOM student must participate in a minimum of 350 patient visits at NUNM Health Centers or at an approved, affiliated community clinic between intern and clinical mentorship rotations. A maximum of 72 patient contacts can be obtained on clinical mentoring rotations. Each MAc intern must participate in a minimum of 250 patient visits at NUNM Health Centers or at an approved, affiliated community clinic.

3.4 Additional Requirements for Graduation

ND

Case Analysis Papers

Students will be required to submit six case papers to their supervising physicians based on clinical cases that they have managed during their last year of clinical training at NUNM.

  • Students in their final four (4) terms of clinical education will submit one or two case papers per quarter. Cases selected will be from different shifts, and submission will begin in summer or fall quarter of the final year for four-year students. Students on the five-year plan or in the concurrent degree program may spread the requirement for six case papers over the final five quarters of their clinical education.
  • Case papers are submitted to the student’s clinical supervisor on the shift where the patient was seen. Completed papers must be turned in by Friday, 5 p.m. of the end of week 9 of the quarter. This allows time for the supervising faculty to evaluate the paper, return it for corrections if necessary, and submit a grade before the end of the quarter. If the paper is not adequate, the supervising physician will return the paper to the student with comments by the end of week 10. The student will make the required changes and resubmit the paper by the end of week 11. The supervising physician will evaluate the papers, grade them, and submit the grade forms to the Registrar’s Office with their term grading sheets.
  • Late papers will not be accepted.
  • Students will select cases from their clinic shifts. It is preferable to select cases for which the student has had a follow-up visit. In certain instances, students may select patients to write up that they have seen once, but who were not able to return to the clinic to see that student. In these instances, the student will clear the case selection with their supervising physician on the shift before writing the case paper. The physician will determine if the patient is appropriate for the purpose of this educational requirement.

Requests for chart copies must be submitted, on the provided request forms, to NUNM Health Centers’ medical records department. Students must allow at least one (1) week for the chart copy request to be fulfilled, so plan accordingly.

Clinical Proficiency Objectives (CPOs)

In order to receive credit for clinical proficiency objectives (CPOs), students will submit a completed “Clinical Proficiency Objective” form to the Registrar’s Office (there are drop-off boxes located in the health center conference rooms as well). Forms are available at NUNM Health Centers–Lair Hill and at the Registrar’s Office. Students may record more than one completed objective on each form, but each objective must be initialed by the supervising physician, as well as having the supervisor sign at the bottom of the form.

Students may not receive credit for completing CPOs while working with preceptor physicians, unless the preceptor is also a supervising physician at NUNM Health Centers.

The Registrar’s Office supplies students with an up-to-date record of completed CPOs at the end of each term. Students are responsible for keeping the yellow copy of the CPO form for their records, and should notify the Registrar’s Office of any discrepancies between their records and the clinical proficiency status report.