For the complete documentation index, see llms.txt. This page is also available as Markdown.

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

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Abdominal Pain (Adult)

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Acid-Base Disorder

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Altered Mental State

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Anemia

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Chest Pain

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Chest X-Ray Interpretation

Interpret pertinent patient data by systematically reviewing a chest radiograph; identify normal structures and major pathological findings

DX

Congestive Heart Failure

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Diabetes Mellitus

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Dyspnea / Shortness of Breath

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Electrocardiogram (EKG) Interpretation

Interpret pertinent patient data by systematically reviewing an EKG; identify rate, rhythm, axis, and major pathological findings

DX

Fever (Adult)

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Fluid or Electrolyte Disorder

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Gastrointestinal Bleeding

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Liver Disease / Injury

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Pneumonia

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Renal Disease

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Substance Use Disorder

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Syncope or Pre-Syncope

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Thromboembolic Disease

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan


Neurology — 9 RCEs

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Altered Mental State

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Dizziness

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Gait Dysfunction

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Language Dysfunction / Motor Speech Disorder

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Numbness, Paresthesia, and/or Neuropathic Pain

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Review Brain Imaging Systematically (CT Head)

Interpret pertinent patient data by systematically reviewing a CT head under supervision; identify normal anatomical structures and major pathological findings

DX

Seizure / Spell

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Stroke

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Weakness

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan


Psychiatry — 7 RCEs

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Anxiety (Symptom or Diagnosis)

Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Depression / Mood Disorder

Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Impulsivity

Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Mania

Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Personality Disorder

Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Psychosis

Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Suicidality

Obtain patient history · Conduct mental status exam · Interpret pertinent patient data · Present case including differential, assessment, and plan


Surgery-Anesthesiology — 9 RCEs

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Abdominal Pain (Adult)

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Assess a Surgical Incision for Signs of Healing and Infection

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Assess for Postoperative Pain

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Fluid or Electrolyte Disorder

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

PROC

Demonstrate Appropriate Scrubbing Technique

Active Participation (Full)

PROC

Demonstrate Knot-Tying Technique (Instrument Tie, One-Handed Tie)

Active Participation (Full)

PROC

Perform Airway Management (Mask Ventilation and Endotracheal Intubation)

Active Participation (Full)

PROC

Perform at Least One Dressing Change on a Surgical Wound

Active Participation (Full)

PROC

Perform at Least One Technique for Suturing

Active Participation (Full)


Pediatrics — 12 RCEs

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Abdominal Pain

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Anemia

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Assess Dehydration Status in a Child ≤ 12 Years Old

Conduct physical exam to assess hydration status using age-appropriate clinical criteria

DX

Assess Growth / Developmental Milestones

Conduct structured developmental assessment using age-appropriate screening tools; interpret growth charts

DX

Assess Immunization Status

Review immunization history; identify gaps per current schedule; counsel patient/caregiver

DX

Assess Nutritional Needs

Obtain nutritional history; assess growth and dietary intake; formulate recommendations

DX

Conduct a HEADSSS / SSHADESS Interview

Conduct structured adolescent psychosocial interview using HEADSSS / SSHADESS framework

DX

Fever (Pediatric)

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Neonatal Jaundice

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Pediatric Ear Exam Pathology

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Rash

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Respiratory Illness (Croup, Bronchiolitis, Pneumonia, or Asthma)

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan


OB/GYN — 14 RCEs

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Bleeding, Uterine or Vaginal

Obtain patient history · Conduct physical exam · Interpret pertinent patient data

DX

Cancer History / Staging

Obtain patient history · Conduct physical exam · Interpret pertinent patient data

DX

Pelvic Mass

Obtain patient history · Conduct physical exam · Interpret pertinent patient data

DX

Pelvic Pain

Obtain patient history · Conduct physical exam · Interpret pertinent patient data

DX

Sexually Transmitted Infections

Obtain patient history · Conduct physical exam · Interpret pertinent patient data

PROC

Assist in a Cesarean Delivery

Active Participation (Assist)

PROC

Assist in a Hysterectomy

Active Participation (Assist)

PROC

Assist in a Laparoscopic Surgery

Active Participation (Assist)

PROC

Assist in a Spontaneous Vaginal Delivery (SVD)

Active Participation (Assist)

PROC

Assist in a Vaginal or Perineal Laceration Repair

Active Participation (Assist)

PROC

Demonstrate Appropriate Scrubbing Technique

Active Participation (Full)

PROC

Participate in the Management of a Pregnant Patient in Labor

Active Participation (Assist)

PROC

Perform Indwelling Urinary Catheter Insertion (Female)

Active Participation (Full)

PROC

Perform Obstetric Ultrasound to Assess Fetal Presentation

Active Participation (Full)


Emergency Medicine — 8 RCEs

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Abdominal Pain

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Altered Mental State

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Chest Pain

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Headache

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Respiratory Distress

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Sepsis

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Shock

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan

DX

Trauma

Obtain patient history · Conduct physical exam · Interpret pertinent patient data · Present case including differential, assessment, and plan


Palliative Care — 6 RCEs

Type
Required Clinical Experience
Associated Skills / Level of Responsibility

DX

Complete a VALUES Assessment

Conduct structured values clarification assessment with patient or surrogate

DX

Conduct a Confusion Assessment Method (CAM)

Administer the CAM instrument; interpret findings; discuss with supervising provider

DX

Conduct Edmonton Symptom Assessment System (ESAS) Scale

Administer the ESAS instrument; interpret symptom burden scores; discuss with supervising provider

DX

Neuropathic Pain

Obtain patient history · Physical exam · Interpret pertinent patient data · Present case with assessment and plan

DX

Nociceptive Pain

Obtain patient history · Physical exam · Interpret pertinent patient data · Present case with assessment and plan

PROC

Observe a Family Meeting on Goals of Care

Observation


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