Clinical Microsystems Clerkship (CMC)

The UCSF School of Medicine Clinical Microsystems Clerkship (CMC) is a required longitudinal clinical skills and health systems improvement curriculum for first- and second-year medical students. It integrates direct patient care, health systems improvement, and interprofessional collaboration.

The CMC occurs one day each week throughout Foundations 1, from the start of medical school to the start of clerkships. Guided by communities of practice and workplace learning principles, physician coaches guide small groups of five to six students in clinical skills training and health systems improvement. Students learn medical history, physical examination, clinical reasoning, patient communication, interprofessional teamwork, and health systems improvement. Clinical skills training occurs in both the Kanbar Center for Simulation and Clinical Skills and in authentic patient care settings. Following an introductory immersion week, students contribute actively to improvement efforts aligned with health system priorities at UCSF Health, San Francisco Veterans Affairs Health Care System, and Zuckerberg San Francisco General. Projects have improved quality, safety, value, patient experience, and health disparities. Students’ quality improvement work has been published, presented, and won awards locally, regionally, and nationally. A deeper exploration of student projects is available here.

Selected publications related to the CMC include:

•    Chang A; Pierluissi E; Cornes S; Ishizaki A; Teherani A; Davis J; Hauer KE; Lucey CR. The Clinical Microsystems Clerkship at University of California, San Francisco: Integrating Clinical Skills and Health Systems Improvement for Early Medical Students. Academic Medicine: October 03, 2022

•    O’Brien BC, Zapata J, Chang A, Pierluissi E. Bridging medical education goals and health system outcomes: An instrumental case study of pre-clerkship students’ improvement projects. Perspectives on Medical Education. 2022 Apr 8:1-8.

•    Leep Hunderfund AN; Kumbamu A; O’Brien BC; Starr SR; Dekhtyar M; Gonzalo JD; Rennke S; Ridinger H; Chang A. “Finding My Piece in That Puzzle”: A Qualitative Study Exploring How Medical Students at Four U.S. Schools Envision Their Future Professional Identity in Relation to Health Systems. Academic Medicine: July 05, 2022

•    Gonzalo JD; Lucey CR; Wolpaw T; Chang A. Value-Added Clinical Systems Learning Roles for Medical Students That Transform Education and Health: A Guide for Building Partnerships Between Medical Schools and Health Systems. Academic Medicine: May 2017 - Volume 92 - Issue 5 - p 602-607

The CMC team consists of a skilled group of faculty and staff with expertise, creativity, and commitment. The CMC co-directors design the curriculum. The CMC curriculum coordinators implement the classroom and simulation curriculum. The CMC site directors and site coordinators lead the integration between medical student education and the School's three affiliated health systems.



  • Anna Chang, MD,  Faculty Director (Division of Geriatrics)
  • Susannah Cornes, MD, Faculty Co-Director, Direct Patient Care (Department of Neurology)
  • Sam Brondfield, MD, MA Faculty Co-Director, Clinical Preceptorships (Division of Hematology/Oncology)
  • Lei Choi, MD, MPH, FACP, Faculty Co-Director, Health Systems Improvement (Division of General Internal Medicine)
  • Catherine (Cat) Lau, MD, SFHM, Faculty Co-Director, Health Systems Improvement (Division of Hospital Medicine)
  • Kristin Casey Callaghan, MA, CMC Manager, [email protected]
  • Anna Kozas, MA, Program Manager, Direct Patient Care, [email protected]
  • Jocelyn Faye, MS, Curriculum Coordinator, [email protected]


UCSF Health

  • Therese Denoga, MPH, UCSF Health Site Coordinator, [email protected]
  • Stephanie Rennke, MD, Faculty Site Director, UCSF Health (Division of Hospital Medicine)


  • James Frank, MD, MA, Faculty Site Director, SFVAMC (Division of Pulmonary and Critical Care Medicine)
  • Patricia Runquist, MPA, Site Coordinator, [email protected]


  • Eric Isaacs, MD, Faculty Site Director, ZSFG (Department of Emergency Medicine)
  • TBA, Site Coordinator