ArticleJournal of general internal medicine2026
Current Landscape of the Internal Medicine Clerkship: A National Survey.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
10 authors.
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Abstract
backgroundThe current national landscape of the core internal medicine (IM) clerkship structure is not known. The last study of the IM clerkship structure was conducted in 2017. Since then, the COVID-19 pandemic prompted clerkship directors (CDs) to reevaluate their curriculum and educational strategies. Additionally, there have been national changes in medical education since the last survey.
objectiveTo describe the current education structure in the core IM clerkship.
designA nationally representative, cross-sectional survey of IM CDs at U.S. medical schools. One thematic section addressed the current structure of the core medicine clerkship.
participantsOne hundred forty-one CDs with membership in the Clerkship Directors in Internal Medicine (CDIM). MAIN MEASURES: IM core clerkship structure descriptive data, including duration, educational models, inpatient experiences, ambulatory experiences, and structural changes since the pre-pandemic period. KEY
resultsThe response rate was 80.9% (114/141). Most clerkships use a traditional block model (87.7%) with a median length (IQR) of 8 (0) weeks. IM-specific ambulatory experiences were required in 49.6% of clerkships. The majority (92.0%) of clerkships have returned to in-person didactics since the pandemic. The most common challenges CDs face include ensuring students receive formative feedback, recruiting enough faculty preceptors, and delivering faculty development. Compared to before the pandemic, 34.2% of clerkships report an increase in students per rotation, and 19.3% report a decrease in clerkship length.
conclusionsMost IM core clerkships remain structured as traditional block rotations. A notable number of CDs report an increase in students per rotation and a decrease in clerkship length post-pandemic. Our findings demonstrate that CDs are navigating increasing complexity in the learning environment, as well as structural, institutional, and system-level challenges. Despite this, CDs have maintained stable learner density on rotations and ambulatory training in the IM clerkship.
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