Office of Medical Education

Level 3: Advanced Integration
Frequently Asked Questions

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Requirements

Does the MICU AI count as an internal medicine AI?

No. But it can serve as your second/Student Choice Acting Internship.

Which courses meet the surgery subspecialty requirement?

Under SURG 9550:
     Acute Care Surgery
     Cardiothoracic Surgery
     Neurosurgery
     Orthopaedic Surgery
     Otolaryngology
     Pediatric Otolaryngology
     Plastic Surgery
     Pediatric Surgery
     Surgical Critical Care (SICU)
     Surgical Oncology
     Transplant
     Urology
     Vascular Surgery

Ophthalmology (SURG 9510)
Gynecologic Oncology (OBGY 4504, contact the OB/GYN Coordinator for a non-AI option)
Urogynecology (OBGY 4526)
Interventional Radiology (RAD 7520)

*No more than two weeks of Anesthesia may be counted toward the surgical subspecialty requirement. ANES 9550, ANES 1501 (Clinical Anesthesiology) may count towards half of the requirement.

Can a surgical acting internship count as both the second AI requirement as well as the surgery requirement freeing up more opportunity to take electives?

No. No double-dipping.

Can I overlap a reading month with a light rotation?

No. While your enthusiasm for education is commendable, concurrent coursework for credit is not permitted toward fulfillment of Advanced Integration degree requirements.

I am going into a specialty without an associated acting internship. What would count as a second AI?

The following Acting Internships are available to be taken as your second AI:  

Since there is no AI in my specialty, what are the best options for my second AI? Which AIs make the most sense?

Anesthesiology: SURG 9501 AI Surgical Critical Care

Dermatology: You may want to consider MED 2522 AI Hematology/Oncology as your required Medicine AI.

Pathology: OBGY 4504 AI Gynecologic Oncology, SURG 9522 AI Surgical Oncology

Radiology: SURG 9524 AI Acute Care Service

Are there AI scheduling recommendations for students considering an Internal Medicine residency application?

Students may only enroll in one of the required IM acting internships (MED-2516, 2518, 2522, 2585, 2586). Some students opt to use MED-2517/MED-2417 AI: MICU as their choice AI. Additional suggestions are above under I am going into a specialty without an associated acting internship. What would count as a second AI?  From a residency application standpoint, there are a number of electives that might be used to strengthen your application and/or prepare you for an Internal Medicine residency such as Clinical Cardiology, Outpatient Hem/Onc, Clinical Gastroenterology, Clinical Nephrology, Clinical Pulmonary Medicine, and Endocrinology/Diabetes, well as courses listed under other departments. We encourage you to reach out to your specialty advisor or to one of the deans for students to discuss options.

May I enroll in an acting internship through another institution to fulfill my subspecialty acting internship requirement? All of the spots in the subspecialty acting internships are filled, but a similar course is offered elsewhere.

No. While you may enroll in an approved away rotation to earn Advanced Integration credit, only the aforementioned acting internships (see previous question), supervised by LCOM faculty members, may be used to fulfill the acting internship degree requirement.

I wasn’t able to get an AI in my specialty early enough to have it included on my transcript or MSPE for residency application. What is my best course of action to have a strong application to my chosen specialty?

It is not necessary to have completed your specialty AI before residency applications go out. Program Directors understand that it is mathematically impossible for every student to be able to schedule their Acting Internship before residency applications are submitted. Students may do elective rotations in their specialty, at home or away, and get strong letters of recommendation. Department Chair letters, if required, will be completed for each student who needs one. The important thing is to be engaged in your rotations and perform well! Students are encouraged to meet with their specialty advisors or the Dean for Students to discuss their approach to the application process.

What makes an AI an AI?

An Acting Internship (AI) consolidates and refines the student’s medical knowledge and clinical skills at a level of competency necessary to deliver comprehensive care to inpatients through increased responsibility in the evaluation and management of patients and through closely supervised direct patient care experiences on an inpatient service. Students are expected to perform as part of the resident team in order to attain a level of competence and self-confidence sufficient to be prepared for entering their first year of residency.

Where can I find more information on the Teaching/Scholarly Project requirement?

Complete information on the options for the Teaching Month and Scholarly Project are available in VIC Portal under the "Teaching and Scholarly Project" course.

I've taken four weeks to work on my Scholarly Project but I've found that I need some more time to complete it. May I take additional time for this work and get credit for it?

Yes, you may add additional time for your project as elective research (1007).

Is there a limit around the number of clinical vs. non-clinical electives I can take?

Although there is no limit on the number of non-clinical electives you can take, you should consider the value of each elective choice toward your educational goals. It is suggested that you discuss which electives are more desirable with your specialty advisor, and whether multiple non-clinical electives are the best option for you.

I am a student who is making up a clerkship. Do I have any Advanced Integration enrollment limitations?

You may not schedule any departmental offering until after the prerequisite clerkship is scheduled. SURG-615 is a prerequisite for Emergency Medicine, Anesthesiology and Orthopedics offerings. Both Medicine clerkships (MED-618 and MED-619) are prerequisites for Medicine, Pathology, Radiology, and Anesthesiology.

Is there a limit to the number of courses I can enroll in?

Yes. Federal Aid Compliance regulations and University guidance limit a student’s enrollment to only those credits required to fulfill graduation requirements. At the Advanced Integration Level this is 48 credits.

When does my Advanced Integration schedule need to be complete?

Students are responsible for maintaining a current and accurate schedule in OASIS to ensure that all Advanced Integration Level enrollment blocks are accounted for. Please see the academic calendars for your class posted on the sidebar of the Vermont Integrated Curriculum webpage. Students should monitor wait list statuses. Retroactive enrollment and schedule changes are not permitted. Your schedule in OASIS must reflect all course requirements no later than January 1 of your graduation year. Please see the Advanced Integration Graduation Degree Requirements Policy. Please note that federal education loans are calculated and disbursed on a semester basis and require students to be enrolled in a minimum of six semester credits at all times to be considered eligible. The LCOM academic year is divided into two semesters for billing and aid purposes: spring (January 1 through June 30) and fall (July 1 through December 31).

I am planning to graduate in the spring. What do I need to do?

Ensure that all degree requirements are scheduled by January 1 of your graduation year, in accordance with Policy 565.45 Graduation Degree Requirements: Advanced Integration. This includes taking USMLE Step 2 CK before January, as detailed in Policy 540.70 USMLE Examination Requirements.

In late-January, complete the administrative graduation survey in OASIS to specify how you would like your name and information to appear on your diploma and in event programs. Additionally, be sure to respond to messages from the Communications Department regarding the Commencement Ceremony (attendance, tickets, etc.).

Complete mandatory exit loan counseling conducted by Student Financial Services if you borrowed federal funds for your education. Instructions and further details are sent via email and are also posted in your class section of the Weekly Wire shortly before Match Day. Contact MedSFS@uvm.edu with questions. 

If necessitated by your exceptional circumstance, petition the Associate Dean for Students to participation in the Commencement Ceremony as instructed in Policy 910.00 Commencement Participation.

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During the Lotteries

May I contact a department to secure a spot in a rotation before the lotteries open?

No. That would be unfair to your classmates.

Is there any advantage to logging in first to make my lottery selections?

There is NO advantage to logging in to a lottery first. Lottery participants are chosen at random by the software and then placed according to ranked preferences, not log-in time. In fact, server speed will be slower during the first hours of a lottery because so many users try to access the software simultaneously.

Do I need to do anything other than click on update and log out to finalize my lottery selections?

Nope, that's it.

I was wondering why I see some courses listed in the Course Catalog in OASIS, but I do not see them when I select the "Add Course" tab?

Some courses are unavailable during the lottery. Either because these courses require a student to complete an individualized 'independent study' form to enroll, or because the course (department) has chosen not to include the offering in the lottery process. All courses are made available when the add/drop period opens. The Course Catalog allows students to review all course offerings regardless of when they will become available.

Why am I unable to add a research or reading month during the lotteries?

Most courses of this nature are considered independent studies. They require you to complete an independent study form when you add yourself to the roster. These courses are made available once add/drop opens, after the lotteries.

Two of the electives I was hoping to add are not listed - Outpatient Family Medicine and Orthopedics for Primary Care Providers. Any idea why not? I'm positive they are offered, and I've looked the list up and down...

Both of these courses (FM-1126 and ORTH-8507) are excluded from the lottery because they require a student to complete an individualized 'independent study' form to sign-up. They will be available for enrollment when the add/drop period opens.

How many rotations will I have scheduled during the Electives Lottery?

This lottery will assign as many of your elective selections as it possibly can. However, no students will emerge from the lotteries with a fully complete schedule. Some required courses, such as scholarly project/TA and surgery subspecialties, will not be available until Add/Drop opens after the lotteries.

When the lottery is run, it randomizes all of the participating students, then takes the first student on the list, looks at their selections and tries to place them in the highest prioritized selection. If the selection is already filled it moves to that person's second selection, until they are placed in something or until no open selections remain. Once the whole list of students has received the highest prioritized selection available when each name was chosen, the process repeats itself: all of the students are re-randomized and the software takes the first student off the list and looks at the first selection that has not been tried yet. OASIS continues this process round after round until all of the students have had all of their selections either placed or attempted to be placed.

Will the Electives Lottery schedule me in the same course more than once if I rank multiple months of the same course number?

No. The software will only assign you to one section of the course—the highest ranked month available when your name is chosen. If you are placed in a first choice for a specific course (such as two weeks of lactation consult), the system will disregard your later rankings of the same course for different weeks/months.

Will the Electives Lottery include acting internship spots that remain open after the initial lottery stages?

Yes, the Electives Lottery will include AI rotations that remain open after the initial lottery stages close. Extra spots in pediatrics acting internships will be available in the Electives Lottery; however, students may not schedule more than one pediatrics acting internship through the lotteries. If space remains when the lotteries close, students should contact the departmental coordinator to add a second AI.

May I drop courses confirmed to my schedule through a previous lottery?

Selections in subsequent lotteries may not have a time conflict with offerings confirmed to your schedule through a previous lottery.

• You may drop placements from previous lotteries to make new selections. However once dropped, the spot is immediately available to others to add to their selections. You may re-add it to your selections, but there is no guarantee that the current lottery will place you in the spot again.
• You may NOT drop administratively assigned clerkships.
• Regarding the ability to drop: The lotteries override many add/drop course restrictions. Once the lotteries close and the add/drop period opens, you will not be able to drop restricted courses without contacting the course coordinator for departmental approval.

What happens if I do not participate in the lottery process?

Most students without an Internal Medicine AI and/or required Emergency Medicine course scheduled will be administratively assigned one prior to the Electives Lottery. Students will not be assigned a subspecialty AI. Please note if you are ineligible to participate in the lotteries, no courses will be administratively added.

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General: Once the Add/Drop Period Opens

How do I add a TA rotation?

In January you will receive an email outlining the process for adding a TA rotation. You will submit your top two choices for a teaching month to the Course Coordinator for the Teaching Requirement (MD-1005). Once you have approval for your teaching month, we will enroll you in OASIS.

I couldn't find a four-week long Step 2 study month, only two-week long electives. If I want to take four weeks to study, should I sign-up for two of these 2-week blocks?

Yes. Although if added to your selections during the lottery, you will only be placed in one section and need to add the second two-week section when the Add/Drop Period opens. Please note that the study time is not considered vacation weeks, and that students may only enroll in MD-1080 PRIOR TO sitting for the required USMLE Step 2CK exam.

How long does the Add/Drop Period last? Can I add/drop throughout the rest of the year?

Once it opens, the Add/Drop Period will remain open throughout your entire Advanced Integration year. You can add/drop as you wish within any restrictions configured by individual courses/departments. For example, many courses do not allow a student to self-add/drop within 30 days of the start date of a rotation (though some do). If you want to add/drop a course within the restriction period, you simply contact the course coordinator listed in the course description to have them adjust your schedule accordingly with departmental approval.

May I swap a rotation with another student?

Contact the departmental course coordinator who manages the course roster. Note that FERPA prevents the institution from sharing other student's schedules; the coordinator cannot provide you with the names of other students enrolled in the course. Usually, you will want to contact your classmates to see if anyone is enrolled in the rotation who might be interested in swapping with you. Once identified, you should email the course coordinator with the other student copied to make your request.

I would like to do a one-week or a three-week rotation, rather than the standard two- or four-week blocks offered; is that possible?

Approval for this is rarely granted without extenuating circumstances. You must first get permission from the Course Director, then obtain permission from the Associate Dean for Students. In general, approval is limited to Scholarly Project, research, or reading electives (with extenuating circumstances) because there is no active time commitment from the Course Director for a specific enrollment period.

I am trying to register for a rotation but am unable to do so; what should I do?

You may not add a course or be added to a course from a waitlist until you drop any conflicting courses on your schedule. If you do not have a conflict, the course has likely been configured with restrictions. Contact the departmental course coordinator to request enrollment in the course. Upon approval, they will add you to the course roster. When in doubt about your enrollment status in a course or you are unable to add/drop a course from your schedule, contact the course coordinator.

I have the required 48 weeks of rotations, but I didn't realize I needed to input vacation time for the remainder of the year - does it matter?

It is your responsibility to maintain an up-to-date schedule in OASIS. Vacation weeks should always be added in OASIS. In order to ensure your loans remain in in-school status and therefore avoid a premature grace period, take care with your schedule that an enrollment gap does not exceed ten days.

I forgot to add vacation time and now am unable to do so retroactively. What should I do?

Contact the Advanced Integration Level Coordinator (see Level 3 Resources for Contact Information) with the dates of the vacation weeks that need to be added retroactively. Remember to document future vacation weeks.

Is it possible to request extra days off for interviews during an acting internship month?

Requests for extra days off may not be accommodated during acting internship months. Please plan residency interview schedule accordingly in November, December, and January. An ample number of acting internship slots are available. Please refer to the Advanced Integration Level Attendance Policy.

How do waitlists work?

Until you are approved by the course coordinator from a waitlist, you are not officially enrolled in a course. Once the enrollment has been approved, the course will no longer be highlighted green with a waiting status; instead, it will appear without highlighting as other course on your schedule. If you remain on the waiting list for more than a couple of weeks without receiving approval from or being dropped by the department, contact the course coordinator for more information.

I’ve heard fellow students talking about a Medical Spanish elective. What is this and how can I sign up to take it?

The approved Medical Spanish course is available from Canopy Innovations. The course consists of three proficiency levels of 12 lessons each, specifically tailored to medical professionals and supported by the National Institutes of Health.

***As of September 2022 we are able to offer LCOM students a discount code on new sign-ups for the full Canopy Medical Spanish program (all three levels). Please contact the Advanced Integration Coordinator for the code and instructions.

After signing up through Canopy and submitting payment, you will add yourself to the waitlist for four weeks of MD 1090 Extramural in OASIS and complete the info form for approval. Upon completion of the three levels you must forward copies of your completion certificates to the Advanced Integration Coordinator to receive your final grade. This course is graded pass/fail.

I have been scheduled to take Step 2CK in December in OASIS. I will be taking it in May and I don’t have an option to drop the currently scheduled exam. How do I manage this?

For all M4 students, both the Step 2CK exam and the ACLS requirement are administratively scheduled on 12/31 in OASIS. For both, students will schedule their actual dates outside of OASIS – with the Clinical Simulation Lab for ACLS certification and with the NBME for the USMLE exam—then OME will record their passing grades next to the “dummy courses” in OASIS in order for degree audits to recognize that the graduation requirements have been fulfilled.

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Extramurals/VSLO

Once I have added myself to the waitlist for an extramural and filled out the electronic form in OASIS, how will I know that it's been approved?

The course will no longer be highlighted green with a waiting status. Instead, it will appear without highlighting as other courses on your schedule.

I am interested in doing an away rotation and understanding how to use VSLO, but I would appreciate a few pointers…

Visit the VSLO FAQ page online for some basic info and tips.

Contact the Advanced Integration Coordinator to have your VSLO account activated. You will then receive an email from VSLO with the login information.

The use of VSLO has led to a significant increase in the number of applications that institutions receive from visiting students. Please be patient and understand that each institution has its own method and timeline for reviewing, approving, and scheduling visiting students. It may take a while to receive a response.

Remember that you start your fourth year earlier than students from other schools. It is likely that you will not be able to schedule away electives until June or later because of the rotation schedules of other institutions. Just like at UVM, other medical schools will schedule their own students into their rotations first before they open them up to visiting students.

Unofficial Etiquette: Please be polite to coordinators at other institutions. Getting an outside student set up for a rotation is time-consuming and requires quite a bit of work behind the scenes. We understand that things will happen that are out of your control and you may need to drop a rotation unexpectedly. If you must drop a visiting rotation less than two weeks before the scheduled start date, please contact the host site right away to let them know.

I am interested in a rotation at an institution that does not use VSLO. How do I get started?

Programs that don't use VSLO for visiting student applications will most likely have a paper application and set of instructions that you can print off of their website. There will be a section of the application that requires the Dean, Registrar, or comparable school official to attest to and sign off on your enrollment, student standing, liability coverage, personal health insurance, etc. A letter of good standing may also be required. All application forms and letter requests can be dropped off/mailed/emailed to the Advanced Integration Level Curriculum Coordinator in the OME. Some institutions may have their own online system which will require forms to be completed electronically and items to be uploaded. The coordinator will help with those as well.

Please take note of the different requirements that each institution may have, and feel free to ask questions.

How will I be graded/assessed at an away rotation? What must I do to make sure a grade is returned?

Most host institutions assess the performance of visiting students in the same way they assess their own students. PDF copies of the clinical and research assessment forms for extramurals are available for download on the Preparing for Advanced Integration webpage. The form can also be made available to host institutions through VSLO. In some cases, the host institution will not complete UVM's form and will submit a completed copy of their own form using their particular grading scale. The official final grade will be translated to the UVM LCOM grading scale which is Unofficial Honors (UH)*, Pass (P), or Fail (F). *Please note that the Rules and Regulations of the Larner College of Medicine state that only The Robert Larner, M.D. College of Medicine at The University of Vermont faculty may award an official Honors grade (HON).

Students are responsible for making sure that an assessment form is returned to the OME via email to mmckay@med.uvm.edu, Fax at 803-656-9377, or in hard copy to Given Courtyard N-100, 89 Beaumont Ave., Burlington, VT 05405.

What is the difference between an Extramural and an Intramural?

• Extramural
  • Course number 1090, except for Extramural Research which is 2090
  • Any rotation done outside of the UVM LCOM system under the supervision of non-UVM LCOM faculty
  • May need to be approved by the Medical Education Leadership Team (MELT) if it is not offered through VSLO or as an official elective at an LCME accredited medical school or ACGME accredited residency program. Pre-approved non-traditional electives appear on the List of Approved Extramurals posted on the Preparing for Advanced Integration webpage.
    
• Intramural
• Course number 1095
• A rotation that does not currently exist in the official catalog but will be supervised and assessed by a member if the LCOM faculty
• Includes rotations done at the Connecticut Branch Campus (Danbury/Norwalk) which are not yet in the catalog
• May need to be approved by the Medical Education Leadership Team (MELT)

What is the process for obtaining my medical records for away rotations?

Please reference the guidelines prepared by the Center for Health and Wellbeing for medical students to determine how you obtain your medical records for away rotations. Please plan ahead; UVM Student Health Services requires about ten business days to process your paperwork.

How do I get a transcript uploaded to VSLO?

You must request a transcript from the UVM Registrar’s Office; you request a transcript from the Registrar via your myUVM Portal:

1. In the "issued to" field enter VSLO c/o AAMC
2. In the "send to email address" field enter mmckay@med.uvm.edu.

A PDF of your transcript will be emailed to Michelle McKay, the Advanced Integration Coordinator; she will upload the transcript to VSLO once she receives it.

I need a background check. How do I get one?

LCOM does not pay for background checks for Advanced Integration, but many affordable services are available online. The VSAS website offers several commonly accepted background check options.

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Student Financial Services

How do I afford residency related preparation costs, such as ERAS fees and airfare for interviews?

You may be eligible to borrow additional Federal loan funds for these costs. Contact The Medical Student Financial Services Assistant Director for additional information..

How do I know my total debt at graduation and what steps do I need to take to manage this responsibly?

Students can always track their Federal loan debt by logging into www.studentloans.gov with your FAFSA credentials. You can also log into your servicers website to view your information. For information about your institutional loans, log into your Heartland/ECSI account, https://heartland.ecsi.net/. You can attend the Senior Series, offered in the final semester of your 4^th year, to learn about loan repayment and debt management strategies.

What counseling is offered by Student Financial Services to best prepare me for repayment?

Starting in early February, the Medical Student Financial Services Assistant Director will contact the M4 class (via Weekly Wire & email recipient list), advertising the Senior Series, which consists of webinars, group sessions, and guided conversations tailored just for you! See the sessions offered last year, co2023 Senior Series .We strive to ensure you know about loan repayment options and education debt management and feel confident about your plan for repayment before you depart for your residency.

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