AC505M.40

Family Medicine Elective

Credits: 4.00 CREDITS (Clinical Elective)
Sites: CAM, SOM
Directors: Miller, Katherine Elizabeth
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Open to Exclerks: No (HMS only)
Description:
This elective is designed for students who are seeking an intensive focussed experience in urban community Family Medicine.Students will spend the bulk of this month seeing patients under supervision of family medicine faculty preceptors in affiliated community health centers and/or private group practices in Cambridge, Somerville and Arlington.Students will see the full spectrum of Family Medicine( including Obstetrics and office based procedures in certain circumstances) in the context of a multiethnic community with an emphasis on underserved populations( notably those from Spanish, Portuguese and Haitian Creole- speaking origins).Students will actively participate in the initial formulation of patient assessment and management plans through oral and written presentations.Students will follow the clinical course of these patients' experience during the month.Students will complete a structured Family/Community Study of one patient .This project emphasises the social and behavioral effects on the patient's health and often involves a home visit.
Students will participate in a day of casebased,evidence based discussions on common topics in Family Medicine with their preceptors.
There are no oncall requirements, although there is opportunity for interested students to spend supervised time with faculty covering labor and delivery .Permission of the Course Director is required .
Learning Goals:
Students will learn the central concepts of Family Medicine emphasising the provision of comprehensive appropriate care in a family context to patients of all age groups, and the provision of a "medical home" for that care.
Students will learn the application of culturally competent care in a Family Medicne context
Students will learn the application of evidence-based principles of care in a clinical setting
Students will learn the concepts of Chronic Disease management as applied in a community based setting.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Students are asked to include basic science correlations in their clinical assessments and preceptors are required to comment on this integration in evaluations.
Emphasis on EBM is highlighted by the preceptors in each patient encounter, and a structured exercise ( recently piloted)is performed with 2 patients.
Evaluation:
1. Clinical (75%)
Preceptors are required to give regular constructive feedback to the student during the month. At a mimimum this occurs verbally at midpoint and at the end of the elective. Based on their observations they complete the "HMS Preceptor evaluation of FM elective student " form and submit to the course director online.While there usually are at least 2 preceptor evaluations,there are occasions where the student has worked with several preceptors in one health center. In these cases, a single form will be generated by a representative of the group,after solicitng input from all his/her colleagues.
2. Family/Community Study (25%)
The course director, and the preceptor whose patient has been selected for a final written and verbal presentation complete online the "HMS Evaluation of Family/Community study" form.
3 Final grade
The course director submits a single final paper form ( HMS Primary Care Clerkship Evaluation )incorporating the comments and opinions of all the preceptors, and integrating the performance on both measures, to the registrar.Uncertainties regarding the final grade are resolved by personal communication between the director and the preceptors.
A formal"HMS gradesheet" is also submitted on paper to the Registrar.
Grade Criteria:
High Honors:
Consistently evaluated clincially as performing " consistently above appropriate level" on all categories outlined in "Preceptor evaluation of FM elective student" assessment and ,in almost all cases, producing( both verbally and in writing) a Family /Community Study which reflects exceptional insight and understanding of the patients' issues.These insights are also located within the context of relevant academic literature.
Honors:
Consistently evaluated clinically as performing " most often above approriate level" across all categories outlined in the " HMS Preceptor evalaution of FM elective student" assessment, and , in most cases, producing both verbal and written presentations of a Family/Community Study which reflects detailed engagement and knowledge of the patient' issues.
Satisfactory:
Consistently evaluated clinically as peforming"appropriate to level of training" on all categories outlined in the "HMS Preceptor evaluation of FM student" and , in most cases, producing both verbal and written presentations of a Family/Community Study which reflects a sound understanding of the patients issues.
Unsatisfactory:
Consistently evaluated clinically as performing "occasionally " or
"consistently below approriate level" on all categories outlined in the "HMS Preceptors evaluation of FM student" , and , in most cases,producing a Family/Community study which reflects little engagement and/or understanding of the patients' issues.
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