> For the complete documentation index, see [llms.txt](https://ismms-md-program.gitbook.io/medinfoapp/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://ismms-md-program.gitbook.io/medinfoapp/clerkship-resources/required-clinical-experiences-rces.md).

# Required Clinical Experiences (RCEs)

### What Are RCEs?

**Required Clinical Experiences (RCEs)** define the minimum set of patient experiences every student must complete during Phase 2 clerkships. Each RCE represents a specific clinical situation — either a patient presentation a student must evaluate and manage, or a procedure a student must perform or directly assist with.

RCEs are a core component of LCME accreditation standards. They ensure that every graduating student has encountered a defined breadth of clinical conditions and procedural skills before entering residency, regardless of rotation site or supervising attending.

**Two types of RCEs:**

* **DX (Diagnosis Encounter)** — The student must evaluate or manage a patient presenting with this condition. Associated skills specify what the student is expected to demonstrate for each encounter.
* **PROC (Procedural Encounter)** — The student must directly perform or assist with the specified procedure under supervision. Each PROC carries a defined Level of Student Responsibility.

**Levels of Student Responsibility (PROC):**

* **Active Participation (Full)** — Student performs or demonstrates the procedure independently under supervision
* **Active Participation (Assist)** — Student assists the supervising clinician who performs the procedure
* **Observation** — Student observes and subsequently discusses the encounter with the supervising provider

RCEs are tracked and documented through the clinical experience log. Students are responsible for logging each encounter at the time it occurs. Clerkship directors review completion rates at midpoint and end of each rotation.

***

### RCE Summary — All Clerkships

| Clerkship              |   DX   |  PROC  |  Total |
| ---------------------- | :----: | :----: | :----: |
| Inpatient Medicine     |   19   |    —   | **19** |
| Neurology              |    9   |    —   |  **9** |
| Psychiatry             |    7   |    —   |  **7** |
| Surgery-Anesthesiology |    4   |    5   |  **9** |
| Pediatrics             |   12   |    —   | **12** |
| OB/GYN                 |    5   |    9   | **14** |
| Emergency Medicine     |    8   |    —   |  **8** |
| Palliative Care        |    5   |    1   |  **6** |
| **TOTAL**              | **69** | **15** | **84** |

***

### RCEs by Clerkship

#### Inpatient Medicine — 19 RCEs

<table><thead><tr><th width="74.4296875">Type</th><th width="240.4609375">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Abdominal Pain (Adult)</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Acid-Base Disorder</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Altered Mental State</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Anemia</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Chest Pain</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Chest X-Ray Interpretation</td><td>Interpret pertinent patient data by systematically reviewing a chest radiograph; identify normal structures and major pathological findings</td></tr><tr><td>DX</td><td>Congestive Heart Failure</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Diabetes Mellitus</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Dyspnea / Shortness of Breath</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Electrocardiogram (EKG) Interpretation</td><td>Interpret pertinent patient data by systematically reviewing an EKG; identify rate, rhythm, axis, and major pathological findings</td></tr><tr><td>DX</td><td>Fever (Adult)</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Fluid or Electrolyte Disorder</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Gastrointestinal Bleeding</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Liver Disease / Injury</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Pneumonia</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Renal Disease</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Substance Use Disorder</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Syncope or Pre-Syncope</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Thromboembolic Disease</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr></tbody></table>

***

#### Neurology — 9 RCEs

<table><thead><tr><th width="84.71484375">Type</th><th width="236.4453125">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Altered Mental State</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Dizziness</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Gait Dysfunction</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Language Dysfunction / Motor Speech Disorder</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Numbness, Paresthesia, and/or Neuropathic Pain</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Review Brain Imaging Systematically (CT Head)</td><td>Interpret pertinent patient data by systematically reviewing a CT head under supervision; identify normal anatomical structures and major pathological findings</td></tr><tr><td>DX</td><td>Seizure / Spell</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Stroke</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Weakness</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr></tbody></table>

***

#### Psychiatry — 7 RCEs

<table><thead><tr><th width="85.5859375">Type</th><th width="241.27734375">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Anxiety (Symptom or Diagnosis)</td><td>Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Depression / Mood Disorder</td><td>Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Impulsivity</td><td>Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Mania</td><td>Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Personality Disorder</td><td>Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Psychosis</td><td>Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Suicidality</td><td>Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr></tbody></table>

***

#### Surgery-Anesthesiology — 9 RCEs

<table><thead><tr><th width="86.05859375">Type</th><th width="245.82421875">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Abdominal Pain (Adult)</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Assess a Surgical Incision for Signs of Healing and Infection</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Assess for Postoperative Pain</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Fluid or Electrolyte Disorder</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>PROC</td><td>Demonstrate Appropriate Scrubbing Technique</td><td>Active Participation (Full)</td></tr><tr><td>PROC</td><td>Demonstrate Knot-Tying Technique (Instrument Tie, One-Handed Tie)</td><td>Active Participation (Full)</td></tr><tr><td>PROC</td><td>Perform Airway Management (Mask Ventilation and Endotracheal Intubation)</td><td>Active Participation (Full)</td></tr><tr><td>PROC</td><td>Perform at Least One Dressing Change on a Surgical Wound</td><td>Active Participation (Full)</td></tr><tr><td>PROC</td><td>Perform at Least One Technique for Suturing</td><td>Active Participation (Full)</td></tr></tbody></table>

***

#### Pediatrics — 12 RCEs

<table><thead><tr><th width="91.28515625">Type</th><th width="246.30859375">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Abdominal Pain</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Anemia</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Assess Dehydration Status in a Child ≤ 12 Years Old</td><td>Conduct physical exam to assess hydration status using age-appropriate clinical criteria</td></tr><tr><td>DX</td><td>Assess Growth / Developmental Milestones</td><td>Conduct structured developmental assessment using age-appropriate screening tools; interpret growth charts</td></tr><tr><td>DX</td><td>Assess Immunization Status</td><td>Review immunization history; identify gaps per current schedule; counsel patient/caregiver</td></tr><tr><td>DX</td><td>Assess Nutritional Needs</td><td>Obtain nutritional history; assess growth and dietary intake; formulate recommendations</td></tr><tr><td>DX</td><td>Conduct a HEADSSS / SSHADESS Interview</td><td>Conduct structured adolescent psychosocial interview using HEADSSS / SSHADESS framework</td></tr><tr><td>DX</td><td>Fever (Pediatric)</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Neonatal Jaundice</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Pediatric Ear Exam Pathology</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Rash</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Respiratory Illness (Croup, Bronchiolitis, Pneumonia, or Asthma)</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr></tbody></table>

***

#### OB/GYN — 14 RCEs

<table><thead><tr><th width="95.12109375">Type</th><th width="246.5703125">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Bleeding, Uterine or Vaginal</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data</td></tr><tr><td>DX</td><td>Cancer History / Staging</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data</td></tr><tr><td>DX</td><td>Pelvic Mass</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data</td></tr><tr><td>DX</td><td>Pelvic Pain</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data</td></tr><tr><td>DX</td><td>Sexually Transmitted Infections</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data</td></tr><tr><td>PROC</td><td>Assist in a Cesarean Delivery</td><td>Active Participation (Assist)</td></tr><tr><td>PROC</td><td>Assist in a Hysterectomy</td><td>Active Participation (Assist)</td></tr><tr><td>PROC</td><td>Assist in a Laparoscopic Surgery</td><td>Active Participation (Assist)</td></tr><tr><td>PROC</td><td>Assist in a Spontaneous Vaginal Delivery (SVD)</td><td>Active Participation (Assist)</td></tr><tr><td>PROC</td><td>Assist in a Vaginal or Perineal Laceration Repair</td><td>Active Participation (Assist)</td></tr><tr><td>PROC</td><td>Demonstrate Appropriate Scrubbing Technique</td><td>Active Participation (Full)</td></tr><tr><td>PROC</td><td>Participate in the Management of a Pregnant Patient in Labor</td><td>Active Participation (Assist)</td></tr><tr><td>PROC</td><td>Perform Indwelling Urinary Catheter Insertion (Female)</td><td>Active Participation (Full)</td></tr><tr><td>PROC</td><td>Perform Obstetric Ultrasound to Assess Fetal Presentation</td><td>Active Participation (Full)</td></tr></tbody></table>

***

#### Emergency Medicine — 8 RCEs

<table><thead><tr><th width="97.2890625">Type</th><th width="251.29296875">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Abdominal Pain</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Altered Mental State</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Chest Pain</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Headache</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Respiratory Distress</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Sepsis</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Shock</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr><tr><td>DX</td><td>Trauma</td><td>Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan</td></tr></tbody></table>

***

#### Palliative Care — 6 RCEs

<table><thead><tr><th width="92.60546875">Type</th><th width="256.765625">Required Clinical Experience</th><th>Associated Skills / Level of Responsibility</th></tr></thead><tbody><tr><td>DX</td><td>Complete a VALUES Assessment</td><td>Conduct structured values clarification assessment with patient or surrogate</td></tr><tr><td>DX</td><td>Conduct a Confusion Assessment Method (CAM)</td><td>Administer the CAM instrument; interpret findings; discuss with supervising provider</td></tr><tr><td>DX</td><td>Conduct Edmonton Symptom Assessment System (ESAS) Scale</td><td>Administer the ESAS instrument; interpret symptom burden scores; discuss with supervising provider</td></tr><tr><td>DX</td><td>Neuropathic Pain</td><td>Obtain patient history · Physical exam · Interpret pertinent patient data · Present case with assessment and plan</td></tr><tr><td>DX</td><td>Nociceptive Pain</td><td>Obtain patient history · Physical exam · Interpret pertinent patient data · Present case with assessment and plan</td></tr><tr><td>PROC</td><td>Observe a Family Meeting on Goals of Care</td><td>Observation</td></tr></tbody></table>

***


---

# Agent Instructions
This documentation is published with GitBook. GitBook is the documentation platform designed so that both humans and AI agents can read, navigate, and reason over technical content effectively. Learn more at gitbook.com.

## Querying This Documentation
If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question.

Perform an HTTP GET request on the current page URL with the `ask` query parameter, and the optional `goal` query parameter:

```
GET https://ismms-md-program.gitbook.io/medinfoapp/clerkship-resources/required-clinical-experiences-rces.md?ask=<question>&goal=<endgoal>
```

`ask` is the immediate question: it should be specific, self-contained, and written in natural language.
`goal` is optional and describes the broader end goal you are ultimately trying to accomplish on behalf of the user. GitBook uses it to tailor the answer towards what is most useful for that goal.

The response will contain a direct answer to the question and relevant excerpts and sources from the documentation.

Use this mechanism when the answer is not explicitly present in the current page, you need clarification or additional context, or you want to retrieve related documentation sections.