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Goals and Objectives
The overall goal of the Family Medicine Clerkship is to provide the third year medical student with an understanding of the scope of Family Medicine as a primary care specialty – its breadth and depth, its challenges and joys.
Educational Goals – the Family Medicine Clerkship emphasizes:
- Continuity of care
- Comprehensiveness
- Coordination of care
- Health promotion and health maintenance
- Diagnosis and management of common diseases and patient problems
- Family care
Learning Objectives
- To understand how the family physician solves problems, particularly in the office setting.
- To understand the family physician's "office" approach to acute care.
- To understand the family physician's "office" approach to chronic care.
- To determine the opportunities available for the family physician to provide comprehensive, holistic care to patients, their families, and the community.
- To identify the types of preventive medicine used by the family physician.
- To become acquainted with the spectrum of problems dealt with by a family practitioner.
- To acquire an understanding of the importance of the doctor patient relationship in all aspects of health care delivery.
- To apply the principles of problem based learning in the ambulatory care setting.
Guidelines for the Medical Student
In the preceptor’s office, it is expected that the student will:
- Seamlessly integrate into the existing collaborative office team. Please take time to learn the names and roles of office personnel and be simultaneously respectful of pre-existing workflows and assertive in joining the team.
- Shadow the preceptor and critically observe and learn the science and art of medicine.
- Interview and examine patients (as assigned by the preceptor) alone, introducing yourself as a medical student. Each interview and exam should be reported to the preceptor, along with a diagnosis, differential diagnosis, and/or problem list. Finally, a proposed plan should be discussed, including tests and treatments. (At least 3 patients should be seen per half-day in this manner.)
- Write, type, or dictate the progress note in the SOAP format under the supervision of the preceptor at the completion of the patient’s visit.
- Provide patient education with the preceptor’s approval.
- See patients for follow-up if a visit is scheduled while you are still with the preceptor.
- Identify a patient with an ambulatory problem for a case presentation.
- Evaluate the preceptor’s medical record system.
- Identify and participate in the preventive medicine aspects of the preceptor’s practice.
- Examine the influence that the patient’s illness has on the family, the family’s resources, and the environment surrounding the patient.
- Periodically meet with the preceptor to review learning issues and present them as requested by the preceptor.
Outside the preceptor’s office, the student will:
- Accompany the preceptor on hospital rounds, nursing home visits, house calls, emergency room visits, hospital and/or emergency room call and other appropriate staff functions.
- Perform admission histories and physicals on hospitalized patients who are admitted from the office or emergency room as directed by the preceptor. The student will assist in the management of these patients in the hospital and write daily progress notes as directed by the preceptor.
- Assist or perform procedures on patients in the hospital under the preceptor’s supervision.
- Evaluate and compare Medicaid, Medicare, and Blue Cross/Blue Shield coverage and other insurance in the office and hospital settings.
- Evaluate the preceptor’s use of consultations and referrals.
- Examine the preceptor’s lifestyle, practice style, and personal satisfaction with his role as a family physician.
Roles of the Preceptor
As facilitator, your preceptor will set the stage for you to accomplish the objectives of the Family Medicine Clerkship by letting you interview and examine selected patients so that you can:
- develop your history-taking and physical examination skills with assistance from your preceptor
- hone your ability to generate both a differential diagnosis and an effective problem list with action plan
- identify learning issues that should direct your independent study in the biomedical sciences
- be oriented to the office practice, including its staff, lab procedures, medical records system, and other relevant areas
- seek out appropriate community resources for the case presentation, and for future interaction during the rural medicine month
- as evaluator, your preceptor is responsible for evaluating your performance by giving you his perspective of your strengths and weaknesses. As a minimum, this is accomplished by the mandatory mid-rotation evaluation and the final clerkship evaluation.
- as role model, your preceptor will exemplify what it means to be a family physician by:
- involving you in the full range of activities related to a medical practice (e.g., outpatient and inpatient experiences; business, hospital, medical and community meetings; etc.)
- letting you see the impact of being a physician on lifestyle and family life.
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