16.0 Clinical Internship 5 (T10)

16.1 T9 Early Leave Policy for T10 Preceptorship

16.1.1 Policy

To allow time for students to relocate to a T10 Preceptorship site which is a long distance from Minnesota (ex: Montana, South Carolina, California, New York, etc.).

16.1.2 Procedure

In order to apply for Early Leave, the intern will need to complete the following items:

1. TAC will be pro-rated to 21 TAC hours (27 TAC for full term).
2. Have completed the minimum clinical requirements: 250 Adjustments, 75 Assessed Adjustments, 20 Diagnostic Imaging Reports, 40 Total Cases. (You may apply if you will meet your final case requirement with Clinical Case Studies 2).
3. Submit a signed contract from an approved T10 preceptor.
4. Submit an application signed by your current faculty clinician approving the early leave to the Program Coordinator in Clinical Education.

Once approved for Early Leave, the intern must complete the following items:

1. All faculty clinician time logs and final paperwork must be approved by last day in clinic.
2. Complete all academic and clinical requirements through T9 including electives.
3. Complete the Checkout process with the Program Coordinator.
4. Receive State Board Approval, if necessary.
5. Remain in the Twin Cities until you receive confirmation from the Program Coordinator that you have 1) completed all necessary items and 2) are authorized to leave (a maximum of one week prior to the start date of T10) for your T10 Preceptorship.

16.2 Early Graduation

16.2.1 Procedure and Procedure

Policy:

Students may request an early program completion date that allows the completion of the DC degree program prior to the end of the published academic calendar. A request will be considered only in situations where having to wait for the formally scheduled program completion date would:

1.         prevent a specific, bona-fide employment/practice opportunity; or,

2.         cause a significant delay of several months in licensure eligibility (in situations where there are no options for participation in a postgraduate preceptorship).

Changing program completion dates is a complex process for the University. Under no circumstances will requests be granted that would shorten the term to less than ten full weeks in duration.

Procedure:

1.         Requests for early program completion must be submitted via email to Jill Mulder, the Clinical Education Coordinator of the College of Chiropractic Dept. of Clinical Education, no later than the first Friday of the 10th term.  In this letter, the student must detail the rationale for the early program completion request, including relevant dates and deadlines.

2.         In addition to the written email request for early program completion, the student submits the following to the CoC Dept. of Clinical Education no later than the first Friday of the 10th term:

i)          a letter from the student’s supervising preceptor indicating that the preceptor understands and agrees to the following:

•           the student has requested early program completion;

•           the student’s 10th trimester will be shorter than originally committed;

•           the maximum available Time Away from Clinic hours is 20 hours;

•           the student’s final day of the term with the preceptor will be one day prior to the program completion date.

ii)         verification of passing scores on Part 1-4 National Boards {e.g. the student letter(s) received from NBCE, a screen print including the student’s name from the NBCE website, or an official NBCE transcript}.

iii)        verification of an employment or practice opportunity or the significant delay in licensure eligibility:

•           in policy situation #1, where a job offer is contingent upon the earlier program completion date, the following must be submitted:

•  the employment, associate, or independent contractor agreement
•  the doctor or organization offering the position must submit a letter verifying the validity of the job offer, and that the offer is contingent on the new graduate’s eligibility for licensure by a specific date.

•           in policy situation #1, where the early program completion is required to facilitate the opening of a new practice, the student must submit specific documentation verifying the timing of the planned opening of the practice (i.e. a copy of the business plan and the lease or purchase agreement).

•           in policy situation #2, where the program completion date would result in a significant licensure delay due to an infrequent licensure process, the student must submit documentation of the delay in licensure, (i.e. licensure test dates resulting in > 4 months of non-licensure in a jurisdiction that does not have a postgraduate program).

3.         The Clinical Education Coordinator will circulate the request to the appropriate parties, and written notification of the decision will be provided.

If the request is approved, the student is responsible for ensuring that:

1.         all requirements for the T10 Preceptorship can, and will be completed by the requested date, including the attainment of a minimum of at least 300 documented clinical hours (When approved for an early program completion date, Time Away from Clinic hours are abbreviated to 20 hours.);

2.         arrangements will be made with all departments of the University to be cleared for program completion prior to the revised program completion date. A final transcript and diploma will not be released until all of these requirements are satisfactorily completed.

A student granted an early program completion date must be aware that his/her Preceptorship is done one day prior to the program completion date, and they may no longer deliver clinical care until licensed (or formally enrolled in a postgraduate preceptorship program).

Please note that financial aid during T10 will be amended to reflect the shortened term. Contact Financial Aid if you have questions.

If you have questions about this policy, contact Jill Mulder in Clinical Education.

16.3 Preparing for T10

Begin the process of looking for an Externship early. Clinical Education needs time to send the application, receive it, credential the doctor, and notify the state board. Certain states have deadlines to meet for contracts (e.g. AZ, MT, SD, WI, etc), and applications to complete (e.g. AZ, SD, MT, WI, and others ).

Northwestern requires of DCs the following regardless of the criteria in each specific state:

• MN – 3 years licensed and in practice in the state of Minnesota.
• All other states and countries – 5 years licensed and in practice for at least five consecutive years with the last three years in the current jurisdiction unless otherwise mandated by the State Board.

16.4 Clinical Internship 5

Students planning to remain in a University-owned clinic or who need to stay in a CBI/University site while completing their requirements for part or all of the final term are eligible to begin T10 when the following criteria have been met:

• the T10 faculty clinician, learning agreement & contract, and placement have been approved by Clinical Education;
• T9 checkout process has been verified by Clinical Education as complete;
• T10 orientation has been completed and the T10 quiz passed with a score of 100% (Moodle);
• registration in Clinical Internship 5 has been completed with the Registrar’s Office;
• T9 term has ended and the T10 term has started;
• Clinical Education has authorized you to begin your 10th trimester internship.

Students may leave a University/CBI clinic for a T10 Preceptorship experience when the following criteria have been met:

• the T10 faculty clinician, learning agreement & contract, and placement have been approved by Clinical Education;
• all internship requirements (i.e. quantitative, Meta-Competency Outcomes, rotations, and paperwork) have been verified by Clinical Education as complete;
• T9 checkout process has been verified by Clinical Education as complete;
• all T1-T9 courses, including required electives/selectives/health promotions, have been verified as complete;
• T10 orientation has been completed and the T10 quiz passed with a score of 100% (Moodle);
• registration in Clinical Internship 5 has been completed with the Registrar’s Office;
• the T9 term has ended and the T10 term has started;
• Clinical Education has authorized you to begin your 10th trimester internship.

Students who have signed contracts with an authorized doctor in a clinical placement approved by Clinical Education are covered by malpractice insurance and qualify for earning credit toward completing requirements for graduation. Students who have not turned in a signed contract and/or are doing clinical activities without the authorization of Clinical Education will not receive credit toward completing requirements for graduation and are not covered by malpractice insurance.

16.5 T10 Requirements

Below are listed requirements for the 10th trimester:

1. A learning agreement and signed contract by both the extern and qualified preceptor must be submitted to Clinical Education by the specified deadline (varies each term).
2. In order to pass Clinical Internship 5 and graduate, students must complete, at least, 300 clinic hours. This overrides the 2 options below.

   During the first week of T10, students need to complete the full 25 minimum clinic hours during that week.

   During the last week of the term, students do not need to complete the full 25 hours minimum, but must be in clinic at least 6 – 10 hours during that week.

3. Complete a minimum of 25 hours per week, and maximum of 40 hours per week, with a total minimum of 300 clinic hours for the term. Although, if you meet the 300 clinic hours before the end of the term, you may not end the term early. You must remain in clinic through the last day of the term.
4. Thirty (30) of these 300 hours may be used as TAC, which must be arranged with your Preceptor. Externs must be at their clinic site for the entire term, except when using TAC hours. If TAC is use, the intern is responsible for ensuring they will meet the required clinic hours by the end of the term. 
5. Create and submit T10 Assignments via Moodle/Survey Monkey. Instructions for the assignments are online in Moodle Clinical Internship 5.
6. Complete Time Log on a daily basis in eMedley. Faculty clinician must approve at the end of each month – clinic hours are required for T10.
7. Faculty clinician must complete and approve a Midterm and Final Summary-CEX evaluation. These web links will be sent to your faculty clinician via email from the Clinical Education Dept. 
8. A Preceptorship Experience Evaluation must be completed by the intern and submitted by the end of the term.

16.6 T10 Externs Contracted with Family Members

Clinical Internship 5 externs may contract with family members.

Considerations

Doing a Preceptorship with a family member has its challenges:

• With a family member evaluating an extern, the validity of the evaluations and feedback could be in question. There is a greater likelihood of the evaluations and feedback being less objective.
• With family members, it often is difficult to maintain the role of clinician and extern. Faculty clinicians who are family often revert to their family role instead of being a clinical mentor. The parallel dynamic often happens with the extern.
• Externs completing an externship with a family member are often related to as an employee instead of a soon-to-be doctor. This changes the dynamics and learning outcomes of the Preceptorship.
• Externs intending to practice with family members, and do a Preceptorship with them, are limiting their variety of internship experiences.

16.7 Non-compete Clauses – Clinical Internship 5

Externs participating in the T10 Preceptorship program may be asked by their preceptor to sign a non-compete clause. The following information is specific to this situation:

• It is acceptable for doctors supervising 10th trimester externs to ask them to sign a non-compete statement. A non-compete statement ought to be reasonable with respect to distance and duration and take into consideration the chiropractic and community demographics of the local area.
• Externs have the option of negotiating the terms of the non-compete statement.
• Externs have the option of not signing the non-compete statement.
• The faculty clinician has the option to not accept an extern who will not sign a non-compete statement.

Clinical Education has the following expectations about non-compete statements:

• Clinicians who want externs to sign a non-compete statement will present the statement to the extern prior to negotiating the T10 Learning Agreement & Contract, and therefore, also before the extern starts the T10 externship;
• Neither the faculty clinician, nor the extern, will require renegotiation of the non-compete statement after the T10 contract is signed or after the externship commences;
• If either party requests a renegotiation of the non-compete statement after the T10 contract has been signed, neither party will make continuing the externship placement contingent on renegotiating the non-compete statement.

16.8 Employment Policy

Interns/Externs may not be employed at the site of their internship. Also, interns/externs will not be assigned to the site of their employment. Interns/externs assigned to a University clinic cannot be employed in that clinic. Interns/externs employed by the University may be assigned to a University clinic if the responsibilities of their employment are not directly related to the specific clinic to which they are assigned.

Interns/externs cannot enter into an employee/employer relationship during an internship / externship (preceptorship) assignment or opportunity; thus, no compensation can be made to the intern/extern. See 1.8 Definition of Unpaid Internship.

16.9 Preceptor Responsibility

Clinical internship requires a contract between a specific extern and faculty clinician. This faculty clinician needs to be physically on-site and immediately available to the extern during the externship. Alternative arrangements need to be made if the faculty clinician is not physically on site and available to the extern. To receive credit for clinical hours and activities, the alternative arrangements must be approved by Clinical Education in advance of the primary doctor’s absence. The faculty clinician must complete and approve all Time Logs in eMedley, Midterm and Final Evaluations in Survey Monkey.

16.10 Post-graduate Preceptorship Program

This program can be utilized in some states between graduation and receiving a Chiropractic license. The states participating in this program do so either through Northwestern or the specific state. In Minnesota, it is through the Minnesota State Board of Chiropractic Examiners. Minnesota doctors must have been licensed and in practice five or more years.