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University of California, Riverside School of Medicine

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School of Medicine Undergraduate Medical Education

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  • Medical Education & Curriculum
    • LACE Curriculum
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      • Internal Medicine & Surgery
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      • Back to Basics
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      • UCR SOM Competencies - App. 1
      • Presentation Skills and Pocket Cheat Sheet - App. 4
      • Clerkship Completion Rules - Year 3 - App. 7
      • Grading and Evaluations for Pediatrics, OB/GYN, Psychiatry, Internal Medicine, and Surgery - App. 8
      • MS 4 Advisor Guide - App. 15
      • Student Fatigue Mitigation Policy - App. 16
      • Healthcare Conflicts with Religious Days - App. 17
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Forms and Documents

Appendix Items

  • Appendix #1 - UCR SOM Competencies
  • Appendix #2 - Contact Information
  • Appendix #3 - Sample Forms for Patient Care
  • Appendix #4 - Presentation Skills and a Pocket Cheat-Sheet
  • Appendix #5 - Clerkship Grade Appeals Form
  • Appendix #6 - Clerkship Remediation Plan
  • Appendix #7 - Clerkship Completion Rules in Year 3
  • Appendix #8 - Grading and Evaluations for Pediatrics, OB/GYN, Psychiatry, Internal Medicine, and Surgery
  • Appendix #9 - Please see Assessment Forms below
  • Appendix #10 - Critical Care Assessment Forms and Grading Rubrics
  • Appendix #11 - Grading Rubric (2018 vintage) for SOAP Note, used in OSCEs Only
  • Appendix #12 - Research Elective Request Form
  • Appendix #13 - School of Medicine MS4 Expectations
  • Appendix #14 - Scholarly Activity Elective Request Form
  • Appendix #15 - MS4 Advisor Guide
  • Appendix #16 - Student Fatigue Mitigation Policy, 2020-2021 Academic Year
  • Appendix #17 - Healthcare Conflicts with Religious Days

Assessment Forms

Mid-Clerkship Assessment Forms

  • Mid-Clerkship Mini-Assessment by Faculty or Resident Supervisor Form
  • Mid-Clerkship Formative Assessment by Student and Faculty Form
  • Mid-Clerkship Formative Assessment by Faculty Form

Other Assessment Forms

  • H&P Observation Form
  • Sample Episodic Feedback Form for Psychiatry
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Riverside, CA 92521

Tel: (951) 827-1012

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