Required Clinical Experiences (RCE) Process

This process establishes a standardized, institution-wide process for the definition, implementation, tracking, and oversight of Required Clinical Experiences (RCEs) across all required clerkships at the Jacobs School of Medicine and Biomedical Sciences (JSMBS). It fulfills LCME Elements 6.2 and 8.6 and ensures that the Standing Committee on Medical Curriculum, as the governing body, has the aggregate data needed for continuous quality improvement.

This process applies to all medical students enrolled in required clinical clerkships, all Clerkship Directors, all Clerkship Coordinators, and all clinical faculty and residents who supervise, teach, or assess medical students during required clerkships.

All medical students at JSMBS are required to complete the RCEs defined in their clerkship syllabus, including at minimum one observed, direct clinical skills encounter (Mini-CEX or equivalent) per clerkship. RCE requirements must be met to satisfactorily complete each required clerkship and to advance from Phase 2 to Phase 3. When a specific patient encounter or clinical skill cannot be met, an approved alternate method must be used. Alternate methods may not replace more than 20% of required encounters in aggregate or at any individual site.

For each required clerkship, the Clerkship Director, in consultation with clerkship faculty, defines:

• The patient types and clinical conditions students must encounter
• The clinical skills and procedures students must perform or observe
• The appropriate clinical settings for each experience
• The expected level of student responsibility for each encounter (see Section 4)
• Approved alternate methods for each RCE in the event a direct encounter is unavailable
• One required observed direct clinical skills encounter (Mini-CEX or equivalent) per clerkship

RCE lists are reviewed and approved annually by the Standing Committee on Medical Curriculum prior to the start of each academic year.

Each RCE must specify the expected level of student participation.

Students are responsible for:

• Logging each required encounter or approved alternate method in the Passport System, including level of responsibility
• Completing the required observed direct clinical skills encounter (Mini-CEX or equivalent) per clerkship
• Reviewing their RCE log with the Clerkship Director or designee at the required midpoint feedback session
• Reporting to the Clerkship Coordinator and Director if they are unable to access a required encounter type
• Achieving full RCE completion prior to completing the clerkship

Clerkship Coordinators serve as the primary operational monitors of RCE completion. Each CC is responsible for:

• The Passport System automatically sends reminders to the students via email 5 days prior to the end of the clerkship summarizes the items logged and those not yet completed
• Reviewing student RCE logs in the Passport System mid-way through the clerkship, 1-week prior to clerkship completion, and at the end of clerkship completion
• Students missing RCEs receive a grade of “Incomplete” for the clerkship until all RCEs are met.
• Flagging students who are behind on RCE completion and escalating to the Clerkship Director
• Tracking the use of alternate methods in the Passport System

Clerkship Directors provide clinical oversight and academic accountability for RCE completion. Each CD is responsible for:

• Defining, reviewing, and updating the clerkship RCE list annually, including approved alternate methods, and submitting to the Standing Committee on Medical Curriculum for approval
• Ensuring all clerkship syllabi include the complete RCE list, alternate methods, expected levels of responsibility, and consequences for non-completion
• Conducting or designating a qualified faculty member to conduct the required midpoint feedback session (see Section 8) for every student, with explicit review of RCE completion status
• Reviewing site-specific RCE completion rates and alternate-method usage annually and presenting findings to Phase 2 leadership and the Standing Committee on Medical Curriculum
• Documenting and reviewing the rationale for any use of alternate methods, ensuring alternate methods are not used as a routine substitute for direct patient encounters
• Communicating RCE requirements, learning objectives, and supervision expectations to all supervising faculty and residents at minimum annually, prior to the start of each academic year

Approved alternate methods include but are not limited to: related patient encounters of a comparable type, supplemental clinical skills, simulation, standardized patients, observed procedures with faculty attestation, and case-based learning as determined by the Clerkship Director.

Alternate methods are subject to the following constraints:

• No more than 20% of required encounters for any student may be satisfied by alternate methods
• No more than 20% of students within a clerkship in aggregate may use alternate methods for any single required encounter type
• If the 20% threshold is reached, the Clerkship Director must notify OAQI immediately
• If the 20% threshold is reached in two or more blocks in an academic year, the Clerkship Director must conduct a root-cause analysis and present findings and a corrective action plan to the Standing Committee on Medical Curriculum
• Observed direct clinical skills encounters (Mini-CEX or equivalent, Mid-Clerkship Form) may not be replaced by alternate methods

The Office of Academic Quality and Institutional Improvement (OAQI) is responsible for centralized monitoring of RCE completion and for producing semi-annual aggregate reports to the Standing Committee on Medical Curriculum.

• OAQI reviews the Passport System and Clerkship Compliance Dashboard at the end of each block
• OAQI flags any breach of the 20% alternate-method threshold and notifies the Clerkship Director and Phase 2 Director within 3 business days

OAQI prepares and presents RCE Completion Summary Reports to the Standing Committee on Medical Curriculum at year-end. Each report includes, for each required clerkship:

• Total number of students enrolled
• Percentage of students achieving full RCE completion
• Percentage of students using alternate methods for each encounter type
• Identification of any clerkship or site where alternate-method use exceeded 20%
• Mini-CEX (observed direct skills encounter) and Mid-Clerkship Feedback completion rates by clerkship
• Recommended actions for any clerkship below compliance thresholds
• Compliance with clerkship grading completion within 6 weeks of clerkship end

The Standing Committee on Medical Curriculum reviews this report, approves any proposed changes to RCE lists, and directs corrective actions as appropriate. Minutes of this review are maintained by the Standing Committee on Medical Curriculum.

Students who have not completed all RCEs by the conclusion of the clerkship will have a remediation plan developed in collaboration with the Clerkship Director and the Phase 2 Director. Failure to complete RCEs will result in a grade of Incomplete and may delay advancement from Phase 2 to Phase 3.

Clerkship Directors who do not adhere to this process, including failure to conduct midpoint sessions, failure to submit required reports, or chronic 20% threshold violations without remediation, are subject to review by Phase 2 leadership and may be required to undergo corrective action.

• Effective Date: May 1, 2026
• Review Cycle: Annual (prior to each academic year)
• Process Contact: Office of Accreditation and Quality Improvement (OAQI) 
• Responsible Parties: Clerkship Directors (CD); Clerkship Coordinators (CC) 
• Accountable Body: Standing Committee on Medical Curriculum – Governing Body 
• Consulted: Phase 2 Leadership; OAQI 
• LCME Standards: Elements 6.2, 8.6 
• Related Elements: 8.7, 9.3, 9.4