Family Medicine Outpatient Elective (FAM 608)

Goal

To develop further and refine skills in the diagnosis and management of common problems in urban, inner-city and/or rural ambulatory community-based family medicine practice. Students may opt for a combination elective with psychosocial medicine.

Learning Objectives

By the end of the rotation the student should be able to:

• Diagnose and treat the 20 most common presenting concerns in family practice.
• Demonstrate skills in cultural competency, including caring for patients from different races, ethnicities, and socioeconomic levels.
• Demonstrate understanding of the impact of health insurance, as well as the "safety net" of care for those patients who are uninsured or underinsured, and how this affects patient care.
• Demonstrate understanding of the psychosocial and health literacy barriers to health care that may be endemic in specific populations such as those living in the inner-city.
• Demonstrate understanding of when to use ancillary health providers, such as social workers, home nursing services, outreach workers, and what services they can provide.
• Provide advocacy for patients.
• Identify and assess risk factors such as domestic violence, substance abuse, and illiteracy, and provide appropriate counseling and referral.
• Identify and learn appropriate management of common office procedures.

Objectives Specific to Psychosocial Concentration:

• Identify and initially manage 5 most common psychosocial concerns in primary care.
• Identify when a mental health referral is appropriate.
• Conduct a family history and construct a genogram. Identify when a family meeting would be useful.

Focused Experiences May be Arranged in:

• OB/GYN, Women's Health
• Inner-city, Urban and Rural settings
• Dermatology/Procedures (as available & in combination with others)
• Adolescent Health
• Refugee Health
• GLBT (gay, lesbian, bisexual, transgender)
• Geriatrics with possible home visits

Schedule of Activities

The student will see patients under the supervision of an urban inner-city or community-based family physician preceptor in Rochester. Practice hours vary, as do on-call arrangements. This is primarily an outpatient experience. Students will participate in resident teaching activities, one half-day session per week. Students may also participate in Group Visits, and Procedure Clinic.

Didactic Activities

At the beginning of the elective, students will discuss learning objectives with their preceptor. These objectives should be revisited (and revised if necessary) during the course of the elective. Generally, brief case presentations to the primary preceptor, during or shortly after the patient encounter, will constitute the majority of teaching activities. It is expected that formal feedback sessions will occur at the midpoint and at the end of the elective.

Required Reading

Aquifer Family Medicine Online Cases, and other articles as provided.

Student Evaluations

In order to receive a grade of Passing, the student must attend all sessions, receive a satisfactory evaluation from the preceptor(s), and return their evaluation of the elective prior to grades being posted.