The Harvard Medical School's Office of the Registrar

The Harvard Medical School Exchange Clerkship Program is one of the largest visiting student programs in the country. Each year, the HMS Registrar’s Office places approximately 800 to 900 students from medical schools all over the world into clerkships taught at HMS-affiliated teaching hospitals. Our goal is to send those students into your hospitals who are ready for the clinical experience. To continue this effort, we’d like to take this opportunity to share with you some information about the Exchange Clerkship Program, and to answer some of the more commonly-asked questions received by our office.

The Harvard Medical School Exchange Clerkship Program is one of the largest visiting student programs in the country. Each year, our office places approximately 800 to 900 students from medical schools all over the world into elective clerkships taught at HMS-affiliated teaching hospitals. Our goal is to send students into your hospitals who are ready for the clinical experience. To continue this effort, we’d like to take this opportunity to share with you some information about the Exchange Clerkship Program, and to answer some of the more commonly-asked questions received by our office. Please share this information with your colleagues.

Some data about the program:
Annually, we process over 1,000 applications from final year medical students from schools other than Harvard. Of the eligible applicants, we are able to schedule almost 90% for clinical elective clerkships at affiliated teaching hospitals of Harvard Medical School.

Who is administratively responsible for this program?
The Assistant Registrar at HMS serves as the HMS Exchange Clerk Program Coordinator. Any written or telephone inquiries that you may receive from non-HMS students about clerkships at your hospital should be forwarded to the Assistant Registrar's attention (25 Shattuck Street; Gordon Hall 213, Boston, MA 02115-6092; E-mail address: Exclerks@hms.harvard.edu).

Our office has a formal application which interested students must submit to the HMS Registrar's Office along with the necessary supporting documentation from their home school. In order to provide hospital clerkships with ample notice of a student’s arrival, we require that students apply from 3 months to 6 months in advance. In addition to the existing Exchange Clerk Program, Dr. Joan Reede, Director of the Minority Faculty Development Program, coordinates a visiting clerkship program which is open to qualified minority students from the United States and Canada. Again, these applications are forwarded to us, and the students are scheduled by our office.

Which students are eligible to participate?
To be considered eligible, students must be in their final year of medical school. The educational systems of many non-U.S. or Canadian medical schools range in duration from 4 to 5 or even 6 years. Thus, in a 6 year medical school system (i.e. German medical schools), the student must be in their 6th year to be considered the equivalent of a U.S. 4th year student.

What type of documentation does the Registrar’s Office require before an exchange clerk may be considered for scheduling?
In addition to being a medical student in the final year and completing the HMS Exchange Clerk application, a student wishing to be considered for placement into the HMS Exchange Clerkship Program must provide a current transcript which indicates the successful completion of all of their clinical clerkships to date. We particularly review for course prerequisites. In addition, students are required to provide a letter from their Registrar or Dean stating that they are in good standing and are approved to do the elective at HMS. Students must also submit a completed CORI form. Massachusetts state law requires a CORI (Criminal Offender Record Information) check to be performed on any individual working in a health care facility who has contact with patients or who has access to confidential patient records. An immunization record is also required (for mumps, measles, rubella, etc.) before we will allow a visiting student onto the hospital wards. Finally, we must have proof that the student has personal health coverage and that this coverage extends for the duration of the student’s stay.

Is there a limit on the number of courses visiting exchange clerks may take?
Exchange clerks may be scheduled for up to a maximum of 3 months of elective clerkships at HMS.

What courses are open to visiting exchange clerks?
Many of the clinical electives listed in the HMS course catalog are open to outside students; others are not. Core clerkships and semester-long courses are not open to exclerks. In addition, some elective clerkships accept visiting students from the United States and Canada, but not from foreign countries. We do not allow exchange clerks to do independent studies, nor do we make arrangements for research. If you are uncertain as to whether or not your particular clerkship should accept a visiting student, please contact our office.

Are there any fees or tuition for this program?
All applicants to the HMS Exchange Clerkship Program must pay a $100.00 application processing fee for each month for which they are applying. In addition, international exchange clerks pay a tuition charge for each month they are scheduled. As of September, 2005, tuition is $2,950.00 per month. This tuition represents 1/12 of the tuition paid annually by Harvard Medical School MD candidates.

What to do with inquiries from interested parties that come your way:
Please feel free to forward any phone or mail inquiries you receive about visiting clerkships to our office. In addition, you may direct interested students to our Internet web site, http://www.hms.harvard.edu/registrar/index.html or to our E-mailbox, Exclerks@hms.harvard.edu

Application Deadlines:
In order for us to continue to accommodate the high number of visiting students we do each year, we have to enforce our application deadlines. These deadlines ensure that we have enough time to properly process a student’s paperwork. It also allows us to determine that they have met any prerequisites for your elective, are approved by their home school to take an elective here at HMS, have had the proper immunizations and are ready to be in your clerkship. Please see the list of monthly rotation dates and deadlines below.

What certification do exchange clerks receive from HMS after their clinical experience here?
Upon completion of participation in the HMS Exchange Clerk Program, all exchange clerks receive a certification letter with their grade from the HMS Registrar’s Office, as well as a copy of the evaluation which was submitted by the clerkship course director. Our certification letter confirms that the student completed the clerkship and that they were assigned "the same duties and responsibilities as a final year Harvard student."

Please note: We only require our faculty to fill out the HMS evaluation form. Applicants to the Exchange Clerk Program are informed in advance that HMS course directors are not required to complete any other school or institution’s evaluation forms or paperwork. It is therefore essential that the HMS Registrar’s Office receives the HMS course grade and evaluation in a timely fashion.

Why do we have these guidelines for exchange clerks?
To ensure eligibility, to receive appropriate credit at their home school, and to be covered by the HMS malpractice policy, all students who wish to participate in the HMS Exchange Clerk Program must be scheduled by the HMS Registrar's office. Students participating in the program are expected to adhere to the HMS monthly clinical rotation dates; we do not allow students to vary from the established calendar. In addition, we require that students adhere to our application deadlines. To give our 250+ elective clerkships adequate notice each month of which students to expect on the wards, it is important that we have ample "lead time" to process applications, schedule students and send out gradesheets to the course directors.

Other notes:
In order to continue to accommodate the large numbers of visiting students that we do, we can only process an application for a given month once. In addition, all assignments must be final. If a student is not scheduled or is scheduled into a clerkship they no longer want to take, we cannot consider their application again for the same month or change their clerkship assignment.

As with our own HMS students, exchange clerks are expected to abide by all HMS official policies, rules of conduct/professionalism and guidelines. In our scheduling letter, we encourage exchange clerks to visit our office upon their arrival and obtain a copy of the Exchange Clerkship Program Student Handbook, which is taken directly from the HMS Student Handbook. If you encounter any problems or concerns with Exchange Clerks on your rotation, whether it is related to their English ability or their fund of medical knowledge, please call our office immediately. We will work with you to resolve the situation.

A final word....
The Registrar’s Office at Harvard Medical School believes that communication is our most effective tool to keep the clinical clerkship process running smoothly. Our office is happy to work with course directors, hospital administrators and staff in the ongoing education of medical students.

Please share this information with other faculty members involved in teaching clerkships and with department administrators and staff. If you have any questions or concerns, we can be reached at 432-1515, Monday- Friday, from 9:00 am - 5:00 p.m. Thank you.

THE HARVARD MEDICAL SCHOOL EXCHANGE CLERK PROGRAM