6. Family Medicine Clerkship

Mission and Introduction

The clerkship in family medicine will introduce students to the aspects of family medicine that are applicable to all fields of medical practice including the comprehensive and continuous care provided by family physicians to patients of all ages.

The curriculum will enhance the students’ ability to recognize the importance of family systems and the impact of chronic illness on patients and their families. The health of individual family members, cultural issues, family systems, and their cumulative effect on health outcomes will be highlighted.

The clerkship will emphasize the importance of integrity and medical knowledge in providing patients with the highest quality medical care.

The family medicine curriculum will promote the highest standards of professional behavior and clinical competence while preparing students for the practice of family medicine in diverse patient populations.

The curriculum will enhance student’s knowledge and awareness of the impact of cultural issues and family systems.

Guidelines

The family medicine curriculum will utilize the following guidelines:

• Length: Six Weeks
• Site: Hospital Medical Floors and Family Medicine Outpatient Facilities, residency programs, emergency rooms and family medicine community preceptor’s offices.
• Orientation: The first day of the clerkship the student will meet with a faculty member to discuss the expectations and responsibilities of the student during the rotation. The schedule for work hours and mandatory lectures will be reviewed.
• Schedule: Clinical faculty will work with students precepting patient visits, attending teaching rounds, and attending didactic lectures
• Evaluations: Each student will have a mid-rotation evaluation with feedback and an end of rotation evaluation with feedback on performance of clinical skills such as history and physical exam, communication and medical knowledge.
• Patient Log: Students will be expected to keep an electronic log of patient encounters and be able to present these cases to Clinical Preceptor. A special emphasis will be placed on continuity of care, communication skills, and integration of medical care, preventive medicine and problem solving skills.

Educational Objectives

The family medicine curriculum will assist students in achieving the following educational objectives

Medical Knowledge

• The normal psychosocial development of patients of all ages
• The role of nutrition, exercise, healthy lifestyles, and preventive medicine in promoting health and decreasing risk of disease in individuals and populations.
• The epidemiology of common disorders in diverse populations and approaches designed to screen and detect illness and to reduce incidence and prevalence of disease on an international patient population.
• The knowledge of and provision of effective patient education for the common patient education topics encountered in the outpatient setting.
• Demonstrate the physiological changes that occur in the geriatric population and the ability to develop short and long term treatment plans based on the unique aspects of geriatric patients.

Clinical Skills

• The ability to understand and utilize evidence-based decision making in clinical practice.
• The ability to identify and develop management strategies for the psychosocial issues underlying a patient’s visit.
• The ability to perform and present a focused patient history and a focused physical examination for common problems encountered in family medicine.
• The ability to use the information gained from the history and physical examination to diagnose and to manage patients in a family medicine office.
• Strive for excellence in medical knowledge and quality of patient care through continued life-long learning while recognizing one’s own limitations and appropriate utilization of consultation.
• The ability to identify and understand the principles of End of Life Care, Hospice Care, and Palliative Care

Professional Behavior

• Demonstrate empathy and respect irrespective of people’s race, ethnicity, cultural background, social and economic status, sexual orientation or other unique personal characteristics.
• Demonstrate self accountability, dependability, responsibility, recognition of limitations and the need to seek help while continuing life-long learning.
• Demonstrate humility, compassion, integrity and honesty when dealing with patients, colleagues and the healthcare team.
• Promote self care and wellness for ourselves, our patients and colleagues.
• The ability to identify and understand the principles of ethics including: i. autonomy, ii. responsibilities, iii. beneficence, iv. nonmaleficence, v. equality.

Core Topics:

Students are responsible for knowing the presenting signs and symptoms and management of these problems regardless of whether any patients have been seen in the preceptor ship.

Medical Conditions

• Abdominal pain
• Allergic rhinitis
• Altered mental status
• Asthma
• Anxiety
• Back pain
• Chest pain
• Depression
• Dermatitis (including acne)
• Diabetes mellitus
• Ear infection
• Headache
• Hypertension
• Osteoarthritis
• Respiratory tract infection (including bronchitis, sinusitis, pharyngitis)
• Somatoform disorder
• Urinary tract infection
• Vaginitis
• Well adult exam
• Well child exam

In addition, students completing this clerkship should be able to provide patient education in the areas listed below.

Patient Education Topics

• Adult health maintenance
• Hypertension, patient control
• Asthma management
• Nutrition guidelines, including
• Diabetes mellitus, new & cholesterol and weight loss controlled diagnosis
• Safe sex and contraceptive choices
• Depression
• Smoking cessation
• Exercise
• Stress management

WEB-BASED RESOURCES

Recognition of the clinically relevant differences between the genders:
Describe the nutritional needs of men and women.

• http://www.mcw.edu/gradschool/
• http://www.umassmed.edu/gsbs/
• http://www.gsbs.utmb.edu/
• http://www.smbs.buffalo.edu/

Knowledge and application of strategies for effective learning and improvement

• http://www.ursuline.edu/stu_serv/asc/strategies.htm
• http://www.crlt.umich.edu/tstrategies/tscelc.html

Knowledge of development and changes across the lifespan

• http://www.nichd.nih.gov/

An understanding of nutrition in health and disease

• http://www.fshn.uiuc.edu/
• http://www2.swmed.edu/humannutrition/
• http://www.fcs.iastate.edu/fshn/

An understanding of the science and management of pain

• http://www.aapainmanage.org/
• http://www.painmed.org/
• http://www.aspmn.org/
• http://www.ampainsoc.org/

An understanding of the concept of chronic illness.

• http://nursing.unc.edu/crci/
• http://www.pbs.org/fredfriendly/whocares/ 
• http://www.healingwell.com/pages/
• http://www.dartmouth.edu/dmsk/koop/resources/chronic_illness/chronic.shtml

An understanding of the principles of environmental medicine

• http://www.acoem.org/
• http://oem.bmjjournals.com/
• http://dmi-www.mc.duke.edu/oem/
• http://www.joem.org/

Comprehension of normal human sexual function and sexual dysfunction

• http://jama.ama-assn.org/cgi/collection/womens_sexual_function (requires password)
• http://pubs.ama-assn.org/cgi/collection/mens_sexual_function (requires password)
• http://en.wikipedia.org/wiki/William_Masters_and_Virginia_Johnson