The 36 interactive virtual patient cases in Aquifer Internal Medicine deliver on the learning objectives of Clerkship Directors in Internal Medicine’s (CDIM) General Internal Medicine Core Medicine clerkship curriculum.
Overview
Aquifer Internal Medicine builds clinical competency and fills educational gaps in internal medicine curricula. The course fosters self-directed and independent study, develops clinical problem-solving skills, and teaches an evidence-based, patient-centered approach to health care.

Important Update to Internal Medicine Case 3
Aquifer Internal Medicine 03 – 54-year-old female with Syncope, has been updated, and is now called Aquifer Internal Medicine 03 – Four Patients with Syncope. It is available for all Aquifer Internal Medicine subscribers as of July 1, 2022.
The updated version of this case now follows four different patients instead of one, each of whom has the same concern, but with differing etiologies. By covering four patients with the same concern, the updated case allows students to sharpen their clinical reasoning skills. Learn more…
- Created for educators, by educators, to cover the full range of CDIM’s curriculum
- Available for institutional subscription or for direct purchase by individual subscribers
- Access to Aquifer Calibrate: Transformative Assessments for Clinical Learning Mastery, our innovative system for formative assessment, available with your 2023-24 subscription
- Innovative Clinical Decision-Making Exam in the key features format available at no additional cost
- Proven pedagogy that standardizes experiences—overcoming geography, seasonality, and accessibility
- Evidence-based, peer-reviewed, and continuously updated content
- Self-assessment questions emphasize key content and enable students to test their knowledge and skills
- A wealth of source material, tools, and full references in each case
- Delivered via the Aqueduct teaching and learning platform, which includes user management options, easy reporting on student progress and course usage, plus tools for creating custom courses to match a specific curriculum
Realistic case scenarios that demonstrate best-practices create an invaluable bridge from content to practice for our students. Aquifer Internal Medicine cases help students to develop the clinical reasoning skills critical to becoming a successful practitioner.
Although designed for use by third-year medical students, Aquifer Internal Medicine is an excellent learning tool for many healthcare professionals. Cases can be assigned to supplement clinical experience to ensure students encounter all of the desired cases in internal medicine, removing the chance that they will miss key clinical experiences.
Formerly the Key Features Exam
The Aquifer Internal Medicine Clinical Decision-Making Exam aligns directly with CDIM’s national curriculum and provides a unique way to assess individual students’ clinical decision-making skills. This exam, validated in a recent study published in Academic Medicine, focuses on challenging decisions in diagnosis and management to target critical decision points that students will encounter in clinical practice.
Aquifer Calibrate, an innovative system for formative assessments, is in development for Aquifer Internal Medicine. The new assessments will combine the concepts of test-enhanced learning and distributed practice to facilitate efficient study planning and self-directed learning for students, and identify at-risk students and curricular gaps for faculty.
After completing each case, students will have the option of calibrating their ability to apply their new knowledge and skills by completing five single-best answer vignette style self-assessment questions. Each question includes clear explanations of the correct and incorrect responses for immediate feedback to students. All self-assessment questions for this course are new as of the 2018-19 subscription year.
Internal Medicine 01: 49-year-old male with chest pain
Internal Medicine 02: 60-year-old female with chest pain
Internal Medicine 03: 54-year-old female with syncope
Internal Medicine 04: 67-year-old female with shortness of breath and lower-leg swelling
Internal Medicine 05: 55-year-old male with fatigue
Internal Medicine 06: 45-year-old male with hypertension
Internal Medicine 07: 28-year-old female with lightheadedness
Internal Medicine 08: 55-year-old male with chronic disease management
Internal Medicine 09: 55-year-old female with upper abdominal pain and vomiting
Internal Medicine 10: 48-year-old female with diarrhea and dizziness
Internal Medicine 11: 45-year-old male with abnormal liver chemistries
Internal Medicine 12: 55-year-old male with lower abdominal pain
Internal Medicine 13: 65-year-old female seen for annual physical
Internal Medicine 14: 18-year-old female for pre-college physical
Internal Medicine 15: 50-year-old male with cough and nasal congestion
Internal Medicine 16: 45-year-old male who is overweight
Internal Medicine 17: 28-year-old male with a pigmented lesion
Internal Medicine 18: 75-year-old male with memory problems
Internal Medicine 19: 42-year-old female with anemia
Internal Medicine 20: 48-year-old female with HIV
Internal Medicine 21: 78-year-old male with fever, lethargy, and anorexia
Internal Medicine 22: 71-year-old with cough and fatigue
Internal Medicine 23: 54-year-old female with fatigue
Internal Medicine 24: 52-year-old female with headache, vomiting, and fever
Internal Medicine 25: 75-year-old female with altered mental status
Internal Medicine 26: 58-year-old male with altered mental status and experiencing homelessness
Internal Medicine 27: 65-year-old male with hypercalcemia
Internal Medicine 28: 70-year-old male with shortness of breath and cough
Internal Medicine 29: 55-year-old female with fever and chills
Internal Medicine 30: 55-year-old with leg pain
Internal Medicine 31: 40-year-old male with knee pain
Internal Medicine 32: 39-year-old female with joint pain
Internal Medicine 33: 49-year-old female with confusion
Internal Medicine 34: 55-year-old male with low back pain
Internal Medicine 35: 35-year-old female with three weeks of fever
Internal Medicine 36: 49-year-old male with ascites
From Our Cases
New Educator Guide Available

Course Overview – Integration Strategies – Case Synopses – Learning Objectives – Features & Resources
The Educators Guide—available to all subscribers—provides a quick reference guide for all cases, resources, and features included with Aquifer Internal Medicine. The Educator Guide is ideal for educators who are getting started using Aquifer, or experienced users who want to be sure they are taking advantage of Aquifer’s extensive resources and tools.
Educator Guides are available in the Educator Resources section of your Aquifer account. Learn more…
User Story Video
Learn how Aquifer Internal Medicine can benefit medical students and faculty in your program: