Clinical Curriculum
MEDEX maintains and cultivates a substantial pool of potential sites and preceptors throughout the WWAMI states and Hawaii, and expects students to travel during the clinical phase of their education. Students entering their clinical year can expect several exciting and educational experiences while rotating through our six-state service region. The clinical year is made up of ten rotations and all students are required to participate in each rotation. The core clinical placement, called the preceptorship, runs for four months in a family medicine environment. The six one-month placements are known as clerkships. The clerkships are further broken down into the required rotations—behavioral medicine, emergency medicine, surgery, inpatient medicine, family medicine, and two electives. Students will either begin the clinical phase with their preceptorship or it will be their last rotation of the year. There are multiple factors taken into consideration when deciding the order in which a student completes these rotations. Throughout the clinical year, students also:
- Prepare for the PANCE and post-graduation practice
- Complete a comprehensive Summative Evaluation in their final quarter
The total clinical education (Fall, Winter, Spring, Summer) accounts for 85 credits.
Course Descriptions
MEDEX 589 Family Medicine I (8 credits)
MEDEX 590 Family Medicine II (8 credits)
MEDEX 591 Family Medicine III (8 credits)
MEDEX 592 Underserved Family Medicine (8 credits)
Primary care and family medicine are central to the MEDEX mission, which is why a significant portion of the clinical year is dedicated to primary care experiences. These rotations emphasize ambulatory care and focus on common medical problems, biopsychosocial factors, preventive care, and the evolving role of the primary care provider.
Students are placed in a variety of settings, including community clinics, large healthcare systems, independent practices, and small group clinics. Across these sites, they gain hands-on experience in diagnosing and managing patients using office-based, hospital, home, and community resources.
The Family Medicine curriculum is structured into four one-month courses:
- Family Medicine I focuses on pediatrics and includes the PAEA Pediatrics End of Rotation Exam.
- Family Medicine II emphasizes women’s health and includes the PAEA Women’s Health End of Rotation Exam.
- Family Medicine III centers on general primary care and includes the PAEA Family Medicine End of Rotation Exam.
- Underserved Family Medicine takes place in a medically underserved setting and includes a reflective writing assignment. Students work with patients at higher risk for poor health outcomes due to limited access to healthcare resources, gaining valuable insights into social determinants of health and health equity.
MEDEX 593 Inpatient Medicine (8 credits)
During this rotation, clinical students will gain essential experience managing high-acuity medical and surgical patients in a hospital setting. They will refine key clinical skills, including history-taking, physical examination, diagnostic test interpretation, and understanding of treatment protocols—all within the context of caring for acutely ill patients.
Students will actively participate in daily rounds and structured training sessions. Additional experiences may include collaborating with consulting specialists and engaging with a multidisciplinary care team to deliver comprehensive patient care.
This Supervised Clinical Practice Experience (SCPE) includes the PAEA Internal Medicine End of Rotation Exam.
MEDEX 594 Surgery (8 credits)
During this rotation, students will expand their understanding of surgical conditions and procedures, while being introduced to the fundamental principles of surgical management. They will actively participate in the preoperative, intraoperative, and postoperative care of patients.
The rotation also exposes students to the management of surgical emergencies and the outpatient follow-up of recently discharged patients, providing a comprehensive view of the surgical care continuum.
This Supervised Clinical Practice Experience (SCPE) includes the PAEA Surgery End of Rotation Exam.
MEDEX 595 Behavioral Medicine (8 credits)
This rotation provides students with both active and observational experiences in a variety of behavioral health settings, including outpatient clinics and inpatient treatment facilities. Placement sites may include state and federal correctional institutions, substance abuse treatment centers, outpatient clinics, and large multidisciplinary medical centers.
Students will encounter a wide range of psychiatric conditions and will participate in patient evaluation and treatment. This may include counseling, medical management, mental health assessments, and collaboration with healthcare providers through consultation.
This Supervised Clinical Practice Experience (SCPE) includes the PAEA Behavioral Medicine End of Rotation Exam.
MEDEX 596 Emergency Medicine (8 credits)
During this rotation, clinical students will encounter a broad spectrum of patient presentations, ranging from common outpatient complaints to critical, life-threatening conditions that demand rapid assessment and immediate intervention.
Students will gain experience in the fast-paced environment of the emergency department, developing the skills needed to efficiently evaluate, diagnose, and manage acute and serious illnesses. This rotation emphasizes quick clinical decision-making, prioritization of care, and exposure to a wide array of emergent conditions.
This Supervised Clinical Practice Experience (SCPE) includes the PAEA Emergency Medicine End of Rotation Exam.
MEDEX 597 and 598 Elective (8 credits each)
Clinical students participate in two elective one-month clinical experiences tailored to their individual interests and career goals. While each elective must be medically focused and relevant to physician assistant practice, the scope of options is otherwise broad—limited primarily by the student’s initiative and professional aspirations.
Students often choose electives that align with their intended specialty or desired employment setting, though it is also common to pursue additional experience in a previously completed core rotation.
There is no PAEA End of Rotation Exam associated with elective Supervised Clinical Practice Experiences (SCPE).
MEDEX 602 Preparing for Practice (5 credits)
The Preparing for Practice course equips students with essential skills to support a successful transition into clinical practice as a physician assistant. The course emphasizes PANCE preparation and addresses other critical components of professional readiness, including practical, clinical, and administrative aspects of PA practice.
As part of this course, students complete a comprehensive Summative Evaluation, which includes:
- PAEA End of Curriculum Exam
- Summative Clinical Reasoning Assessment (CRA)
- Summative Essay
- Summative Technical Skills Assessment