UNIVERSITY OF TORONTO 
                              FACULTY OF MEDICINE 
                   SURVIVING CLERKSHIP 
                          A PRACTICAL GUIDE 
              
                               EIGHTEENTH EDITION 2019 
                                               
                                         Editors: 
                 Jordan Lewis, Chris Adams-McGavin & Rohan Philip 
                                       Class of 2T0 
                                               
                                    Associate Editors: 
                           Hetshree Joshi and Maham Bushra 
              
                                      Sponsored by: 
                               MD Financial Management 
       Previous Editors 
       SEVENTEETH EDITION, 2018 
       Robin Mawson & Juliet Shao (IT9) 
       SIXTEENTH EDITION, 2017  
       Linda Chow & Roland Xu (1T8) 
       FIFTEENTH EDITION, 2016  
       Dhruvin Hirpara, Narayan Chattergoon & Marcus Tan (1T7) 
       FOURTEENTH EDITION, 2015 
       Pavel Ketov, Alex Wasserman & Jason Woodfine (1T6) 
       THIRTEENTH EDITION, 2014 
       Hassan Masoom, Mohammed, Sabri Attia & Nadia Salvo (1T5) 
       TWELFTH EDITION, 2013 
       Anthony La Delfa, Erin Thomas Wong (1T4) 
       ELEVENTH EDITION, 2012                        
       Dahlia Balaban, Erin Spicer (1T3) 
       TENTH EDITION, 2011 
       Corey Boimer, Marcus Miller (1T2) 
       NINTH EDITION, 2010 
       Alex Cheng, Faazil Kassam (1T1) 
       EIGHTH EDITION, 2009 
       Emilie Lam, Akash Patel (1T0) 
       SEVENTH EDITION, 2008 
       Emilie Lam, Akash Patel (1T0) 
       SIXTH EDITION, 2007 
       Tony Tam, Taryn Simms, Nam Le, Amol Verma (OT9) 
       FIFTH EDITION, 2006 
       Charles Kassardjian, June Lee (OT8) 
       FOURTH EDITION, 2004 (reprint) 
       THIRD EDITION, 2003 
       Adam Fleming (OT4) 
       SECOND EDITION, 2001 
       Sharmistha Mishra, Evan Propst, Darren Yuen (OT2) 
        
       FIRST EDITION, 2000 
       Jane Vetiska (OT1) 
       2 / 120                                                                     University of Toronto, 2017   
        
        
                              
       Dear 2T1 Clinical Clerks, 
       The Office of Health Professions Student Affairs (OHPSA) is your confidential, 
       neutral, safe space for support around your learning environment.  Some of the 
       services offered in house include: 
        
       -    Personal Counselling 
       -    Career Counselling/advising 
       -    Academic Coaching and support 
       -    Support for Leaves of Absences 
        
       We also focus on wellness and mental health and are your go-to place for 
       everything match/CaRMS. If we don't have what you need in house, we will link 
       you to other supports within the MD Program, the University, and/or the 
       community.  This could include Accessibility Services, financial support, 
       housing, harassment and diversity matters, and medical/mental health 
       services, as examples. Whatever it is, we're with you.  
        
       Learn more about us by calling 416-978-2764, emailing ohpsa.reception or 
       looking at our website www.md.utoronto.ca/OHPSA.  Stop in or book an 
       appointment with us at http://www.md.utoronto.ca/content/book-
       appointment. 
        
       Our regular office hours are Monday - Friday 9:00am-5:00pm but you can also 
       book after hours appointments at either St. George or Mississauga. Note our 
       new downtown location as of July 1, 2018 is Naylor Building, 3rd floor, 6 
       Queen's Park Cres (north-west side of University and College) 
        
       The OHPSA team 
                                         
       Surviving Clerkship: A Practical Guide                                                  3 / 120 
                        
   TABLE OF CONTENTS 
   Address from OHPSA………………………………………………………………………………  3 
   Table of Contents ............................................................................................ 4 
   Introduction ..................................................................................................... 6 
   General Tips for Success in Clerkship ............................................................. 8 
   Writing Notes ................................................................................................. 10 
    A. The Admission Note ............................................................................ 10 
    B. The Progress Note ............................................................................... 13 
    C. The Surgical O.R. Note......................................................................... 14 
    D. The Procedure Note ............................................................................ 14 
    E. The Discharge Summary ...................................................................... 14 
    F. Dictating ............................................................................................... 15 
   How to Read a Chart ..................................................................................... 17 
   Writing Orders and Prescriptions ................................................................. 18 
    A. Admission/Transfer Orders ................................................................ 18 
    B. Common Order Pitfalls ........................................................................ 22 
    C. Ordering Medications ......................................................................... 23 
    D. Writing Prescriptions .......................................................................... 23 
   Requesting a Consultation ............................................................................ 25 
   Anaesthesia .................................................................................................... 27 
   Dermatology .................................................................................................. 30 
   Emergency Medicine ..................................................................................... 32 
   Family Medicine ............................................................................................ 38 
   Medicine ........................................................................................................ 42 
   Obstetrics and Gynecology ........................................................................... 50 
   Ophthalmology .............................................................................................. 62 
   Otolaryngology – Head and Neck Surgery ................................................... 64 
   Paediatrics ...................................................................................................... 67 
   Psychiatry ....................................................................................................... 73 
   Surgery ........................................................................................................... 84 
   Appendix A: Other Useful Stuff .................................................................... 97 
   Appendix B: Frequently Used Abbreviations ............................................... 98 
   Appendix C: Useful Resources for Clerkship.............................................. 102 
   4 / 120                                                                     University of Toronto, 2017