Frequently Asked Questions
The Rural Integrated Community Clerkship Program (ICC) is a core clerkship for the entire Year 3 of the MD Program. The Rural ICC is based on the 3 principles of longitudinal integrated clerkships: 1) continuity of patient care 2) continuity with teachers and 3) continuity of learning environment and curriculum. Students learn medicine in an integrated manner and follow patients through the varioius venues of care including clinic. Students are placed in selected rural communities for all but 8 weeks of Year 3.
Communities are selected for the Rural ICC based on their history as good teaching sites and where there is a breadth of services in the community that will provide the learning environment in which students will be able to meet the learning objectives of the MD Program for Year 3.
Students in the ICC are in a learning envionment that provides comprehensive care of patients over time and meet their Year 3 Objectives across all of the Year 3 disciplines simultaneously. Students and their teachers will get to know each other well over the year. This will give students an authentic role in patient care and allow appropriately graded responsibility over the year.
The Rural ICC is a member of a worldwide movement of longitudinal integraded clerkships (LICs) which have been implemented in the United States, Australia, Japan, South Africa, the United Kingdom and at six other Canadian medical schools.
The ICC Program hosts a series of three (3) information talks at the beginning of each academic year, dates are posted in medSIS.
The first talk is where you are given a global look into the program.
The second talk is where you are given direct access to our ICC alumni, come get your questions answered directly from those who have been through the program. Come listen to their first-hand knowledge and their experiences about their time in the ICC Program.
The third session, we go over the ICC application process.
You are encouraged to bring your curiosity and your questions to each of our sessions. Come see if the ICC Program is a good fit for you. Each student who applies to the Rural ICC Program will receive an interview - held in early January and will be notified personally if sucessful.
Application Check List
- Application Form ensure to complete each section of the form
- Submit a current CV with your application form
- Submit by midnight, 04 January 2022
If you have questions or concerns regarding the ICC Program, please reach out to us.
Email: iccume@ualberta.ca.
Students are selected on the basis of the ICC application, the CV and an interview.
Some of the characeristics that the Clerkship is looking for is adaptability, self-directedness, ability to deal with uncertainty and willingness to make choices that are off the beaten path.
Students who have taken a leave from their medical studies for three months or more in their second year will be considered but may be requied to use some of their summer weeks prior to ICC to undertake approved electives to prepare for the ICC year.
Students who have failed courses but who have undergone successful remediation will be considered on and individualized basis.
All other students are eligible to apply.
Current communities are listed on the applicatiion form and applicants will be able to rank the sites. The applicaiton gives students an opportunity to specify compelling reasons why particular communites fit their needs (for example, it is the student's home community or it is nearby that community, partner can find work in that community, student has extended family members in the community, etc.). It is also an option to tell us that you would be fine with going anywhere. The program administration strives to give students on of their top 5 choices.
Assignments to communities will be made after acceptances into ICC are offered and accepted by students.
Please understand that there may be changes between application deadline and acceptances. If this is the case, students will be apprised of the changes and will be invited to re-rank the communities.
It is program policy to assign two students to each community for support and collegiality. The student pairing request indicated on applications will be considered, but it will not be the only selection criteria. If students want to be assigned together, the rankings must be the same.
Applicants who are only willing to participate in one community will decrease their chances of being chosen for the ICC program. If a student feels there is a compelling reason that only one site is a possibility for them, they are invited to address this in the application.
The approved community sites are listed here, remember to scroll down
Each rural community selected as an ICC site will provide the learning environment in which ICC students will be able to meet their Year 3 objectives.
General characteristics of communities are as follows:
- History as a successful teaching site.
- Minimum of 500 consultations per week that will involve patients of all ages.
- Continual cover by family doctors who are based in the community.
- At a minimum, a surgical program that would include at a minimum c-sections, endoscopies, and minor surgical procedures.
- Active local obstetrics program that can provide students with a minimum of 10 labour and delivery experiences.
- Capability to undertake inpatient management for common problems in family medicine, internal medicine, obstetrics/gynecology, pediatrics and psychiatry.
- Comfortable residential accommodations for students.
- Access to high speed Internet.
All of our ICC sites have family medicine residents in the community for at least part of the year.
Each student will have 1-2 identified primary preceptors. However, you will work with most of the physicians in the community at some time in the year you are in the community.
Each community has a site co-ordinator. The site coordinator will be responsible for scheduling, ensuring regular feedback and completing student evaluations. This will be done in collaboration with all physicians in the community who are involved in teaching.
In some communities, the ICC site co-ordinator takes on most of the administrative tasks and other physicians assume the main responsibility for teaching. In others, the ICC site co-ordinator also is a primary preceptor.
A typical week will most likely be spent as follows:
- Most days will start with hospital rounds. This will include caring for the obstetrical patients the student will follow.
- Four or five half-days in a family medicine clinic. These responsibilities include ER, following patients in labour, working with visiting specialists, etc.
- Up to one full day in surgery.
- One half-day of Structured Learning Sessions
- One half-day of self-directed study.
- One half-day with other health professionals in the community.
- Students are expected to be on call until 11 p.m. one evening per week.
- Students are expected to be on call one weekend per month. This will include 24 hours of continuous or discontinuous on-call responsibility.
Schedules will vary from between each community to ensure students meet the Year 3 objectives in the context of the community in which they are assigned.
On-call responsibility is to be approached with a degree of flexibility, given the requirement for ICC students to follow obstetrical patients on a 24/7 basis in the Patient Panel.
- Link Block (August) - usually 2+ weeks with the entire class in Edmonton,
- ICC Orientation (September) - 1 week; prior to COVID in a rural community but has been online for past 2 years,
- Rural commuity placement (end-Agust to mid-June) - approximately 40-week
- Two weeks for transition including summative case presentations, summative MCQ/Short answer and OSCE assessments (last 2 weeks of June); some consolidation sessions and sessions with former ICC students to discuss successful transition to Year 4 rotation-bases clerkship.
- Six weeks of electives - (July/August)
Evidence shows that results of the Year 4 MD exams and LMCCs, ICC students are comparable to their colleagues in the rotation-based clerkship. The LIC literature is clear that LIC students are comparable to RBC students.
It has been identified to ICC leads by preceptors in Year 4 that ICC students have more developed procedural skills and clinical confidence (comfort and ability with clinical situations and problems) that isn't misplaced, i.e. that they are also competent. Also many program directors now tell us that they can often tell LIC students in interviews by the depth of experience and ownership of these experiences.
ICC students generally see more patients over the course of their third year. They are advantaged by having a balance between community care settings and acute care settings. Another advantage is the number of patients they see with undifferentiated problems and the learning that comes from developing an appropriate differential diagnosis and initial management and responsibility within their community's health-care team.
Clerkship is fundamentally about clinical experineces and learning with, from and about patients and their problems. Each clerkship in the rotation-based clerkship has its own approach to supplementary learning experiences.
The ICC has adopted weekly Structured Learning Sessions (SLS) to support clinical learning and to provide ICC students with a framework for their self-directed learning outside the clinical environment. These sessions are also a means through which ICC students connect with some of their peers in other ICC communities. SLS includes student case presentations plus a virtual case that is discussed online asynchronously through the week and presented at the SLS the following week. All SLS sessions start with a check-in.
Students will also have access to presentations given to students in the rotation-based clerkship.
The ICC has a series of assessments throughout the ICC:
Formative Assessments:
- Daily informal feedback
- Students will be required to obtain a minimum of two (2) EPA assessments per week at least one of which will be from their primary preceptor
- Periodic formative precepor-based evaluations (MDPA) of student performance will occur approximately every 12 weeks
- MCQ/Short answer and OSCE assessments in February of the ICC year
Summative Assessments (at the end of ICC):
- 45% - Assessment by site-coordinator (end of ICC MDPA)
- 15% - Case Presentation
- 15% - Stiudent in Community Initiative
- 5% - Patient Panel Completion
- 20% - MCQ/Short Answer and OSCE assessments
- 100% - Total
In the previous 14 years of the ICC, all students have matched on the first iteration. Informatoin about first choice of discipline isn't shared with the Clerkship leads but information via former students indicates that most, if not all, match to their first choice of discipline but not necessarily their first choice of location. This is also the case for other LIC programs elsewhere in Canada.
Observations from some CaRMS interviewers suggest that ICC students have an advantage, that they stand out for their experience, their competence and their confidence.
Elective time for ICC students is at the end of the ICC community placement when students are at their best in Year 3. This ensures students who have completed their community placement can showcase their clinical and procedural skills to preceptors in disciplines that they are interested in applying to. There is evidence from CaRMS that doing electives too soon in Year 3 is a disadvantage for many.
For those interested in rural family medicine, the ICC will be a definite advantage for many of rural family medicine residency programs.
Accommodations funded by the Rural ICC and the procurement of accommodations is contracted out to the Rural Health Professions Action Plan (RhPAP).
Each student receives their own accommodation - no sharing. If your partner or family will be accompanying you to your community, accommodations will be secured that are appropriate for your family.
Accommodations are fully furnished with the basics so you will need to take a few essentials with you such as bedding, pillows, towels, groceries and personal items.
All stuent accommodations have telephones with local call access only. They are also equipped with highspeed internet.
Travel to and from the ICC community at the beginning and end of the ICC is covered.
If there is extra travel mandated by the ICC, for instance to a Formative OSCE, travel to those events will also be covered.