Family Medicine Clerkship - TMedWeb - Tulane University · Blueprints Family Medicine Case-based learning Toy EC. Case files family medicine

R A D E N . P E J I C , M . D . A S S O C I A T E P R O F E S S O R O F F A M I L Y M E D I C I N E

Family Medicine Clerkship

Tulane Department of Family Medicine

Course Description

6 week clerkship experience Placed with community family medicine physician Adopt preceptor’s schedule Opportunity to work in variety of settings One-on-one learning in the trenches Experience doctoring where most of it actually

occurs


Goals

Gain knowledge and experiences expected for a T3 regarding first contact ambulatory care.

Understand the 5 core principles of family medicine Understand and respect the role of ambulatory

primary care in the continuum of health care services


Knowledge and Experience

H&P Ddx Work-up Prevention/counseling Office procedures Documentation


Competency

Take accurate history Obtain accurate vital signs Perform basic physical exam and be able to alert

preceptor to abnormal or questionable findings Interpret basic laboratory tests


Competency


Interpret electrocardiograms and plain x-rays Assist with office procedures Perform basic nursing skills, i.e. IM and SC

injections, ekg, phlebotomy, dressings, etc… Direct observation and feedback from preceptor

5 Core Principles of FM

Biopsychosocial Model of Care Comprehensive Care Contextual Care Continuity of Care Coordination/Complexity of Care


Biopsychosocial Model of Care

How suffering and disease are affected by multiple levels of organization, from the societal to the molecular. Also sometimes described in more

practical terms as the embodiment of the mind-body connection.


Comprehensive Care

How a family physician is responsible for appropriately arranging care for all stages of life, recognizing the breadth of knowledge it

takes to be able to manage the diversity of the human experience.


Contextual Care

How a family physician must recognize that the patient's relationships are integral to the

health and wellness of the patient. The relationship a patient has with his or her

family, community, culture, and past experiences impacts their ability to participate

in their own care.


Continuity of Care

The process by which the patient and the physician are cooperatively involved in

ongoing health care management toward the goal of high-quality, cost-effective medical

care.


Coordination/Complexity of Care

The family physician understands that the care of patients is not one individual's job. It is a team-based effort involving other physicians and allied medical personnel. The physician must also use evidenced-based practices tools such as registries, health information exchanges, and other means to ensure patients get safe, effective, and indicated care when and where they need it. Provide culturally/linguistically appropriate care.


Role of Ambulatory Primary Care

Role of family medicine doctor Value of primary care Coordination of care Exposure to health systems issues Office operations, i.e. front desk, coding, prior

authorizations, etc…


Clerkship Structure

1 week of pre-clinical learning sessions 4.5 weeks of clinical preceptorship Return to NOLA the final week for exam prep and

exam


Requirements

Have fun and learn a lot- that means being present Adhere to the honor code Act professionally Represent Tulane in the best way possible Show up Complete required assignments


Requirements

Explore the community, talk to patients and staff, go to local events, etc…

Learn: read, read, read! Study your patients. Adopt your preceptor’s schedule, i.e. ER, hospital

rounds, clinic, call, nursing home, etc…


Requirements

Say “thank you” a lot Preceptors are volunteers Treat clinic staff with respect Treat patients with respect You’re there to learn but recognize when to stay out

of the way


Requirements

Must go to your preceptor’s office Talk to your preceptor about expectations Learn your preceptor’s schedule Review clerkship requirements with preceptor Only 3 excused absences Must make-up any additional missed time


Absences


Check with us first– call/email clerkship coordinator Obtain chit from student affairs You are allowed 3 over the 6 week clerkship Any additional missed time must be made-up

Requirements

Focus on common problems See patients Informal discussions with preceptor Read

Complete observation & feedback card Complete Case Log (PxDx) cards Enter info into E-Value min 120 dx logs (can be multiple per patient) Enter direct observations and patient feedbacks LEAD students enter into LEAD program


Requirements: optional

Student may spend ½ day each week on practice management or community activity.



Practice management Front desk Nursing Lab Medical records Billing



Community Activity AA Nursing home Hospice Home visit Community health activity Patient education meeting Medical meeting


Requirements: Mid-Block Evaluation

Arrange a time to meet with your preceptor Complete your self-assessment first Preceptor should review and comment Opportunity to discuss your progress Opportunity to set goals for remainder of time Opportunity for me to hear your concerns Utilize suggested discussion topics


NBME Family Medicine Exam


90 Core Family Medicine Shelf Taken online in secure environment (Murphy 220) 2 hours and 15 minutes to complete

Study Material


Textbook Rakel RE. Textbook of Family Medicine.

Study guide Lipsky MS. Blueprints Family Medicine

Case-based learning Toy EC. Case files family medicine.

Chest x-ray Goodman, LR. Felson’s Principles of Chest Roentgenology.

EKG Warinner PQ. Pocket Brain EKG and Heart Murmurs.

Study Material


NBME content outline STFM clerkship curriculum Point-of-care references: up-to-date, Dynamed,

clinical key AAFP website and AFP journal

Join the AAFP


www.aafp.org Free student membership Access to study material and full AFP content -- AAFP free membership includes practice test question phone app

http://www.aafp.org/

Grades


Pass the NBME family medicine shelf exam Receive a satisfactory preceptor evaluation Complete direct observation/patient feedback card Complete Case Log (PxDx) data entry Have no unexcused absences

Grades


Pass ≥ 5th percentile High Pass ≥ 50th percentile Honors ≥ 75th percentile --- For students within 1 point above/below the cut-off, their final grade may be adjusted to reflect their overall performance. Preceptor comments, active engagement in the clerkship and professionalism will be assessed.

Failing Students


You’ll be allowed to re-take the NBME exam A passing grade will result in a C/P Students who fail the exam a second time will fail the

clerkship

Contested grade


Must do so in writing within 7 days of the final grade being posted

Grading committee will review your file and issue a final grade within 30 days

Questions?

Ask Mr. Adam Peltz 988-4705 [email protected]

Ask Dr. Rade Pejic 988-4700 [email protected]


mailto:[email protected]

Documents

Family Medicine Clerkship - TMedWeb - Tulane University · Blueprints Family Medicine Case-based learning Toy EC. Case files family medicine