Elective Learning Opportunities
Our Residents have 2 four-week elective rotations in both the second and third year. At least one per year can be an away elective. Some common electives include: ER/Fast Track, Rural Health, Global Health, Sports Medicine, Geriatrics, Hospice/Palliative Care, Adolescent Health, Reproductive Health, High Volume/High Risk OB, School Health, Practice Management/PCMH. Below are testimonials of select residents' experiences.
Block Island -- Primary/Urgent Care
This away elective at the Block Island Medical Center is a mix of primary care, urgent care,andemergency medicine in a low-resource setting. In the summer, the population jumps from the usual 1000 year-round residents to about 20,000 visitors per day, which means more visitors to the Medical Center, and the need for more providers on the island. As residents, we get to see patients independently and also get to supervise medical students with attending back-up. We get to do everything from diabetes management to laceration repairs to fracture management, which also means that we often have to do our own labs and x-rays. We also see many emergencies, including traumas, strokes, and MI's, so we have to decide how to best get the patient off the island and to a trauma center- this can happen by boat, helicopter, or airplane, and sometimes the weather doesn't always cooperate! There are also weekly to bi-weekly lectures led by the Medical Director and many opportunities to present interesting cases to the group of residents/students. Housing is also provided on the island, and it's right across the Medical Center, which is super convenient for those middle-of-the-night calls!
Care for Homeless Populations
One of the things that drew me to Brown was the opportunity to care for underserved patients in a variety of settings. I was able to rotate with the family team at Boston Healthcare for the Homeless learning about the systems they’ve established to care for homeless and housing insecure patients in their community. I accompanied the team on home visits, at clinics in homeless shelters and for outreach and education activities including a health fair. Closer to Providence, I was able to work longitudinally with House of Hope, a community development corporation that operates in and around Providence. I accompanied team members on street outreach and was able to provide care on Shower to Empower, a mobile outreach unit that offers showers, haircuts and basic medical care. Additionally, core training provided by our program in social determinants of health, substance use disorder care and trauma informed care helped prepare me for my future work in homeless healthcare.
One of the great things about being part of Brown University is the camaraderie across the various departments and the openness of those departments to take on family medicine residents as learners. I was able to very easily arrange a broad adolescent health experience with the support of the Department of Adolescent Medicine at Hasbro Children’s Hospital by reaching out to their coordinator directly. The experience in adolescent medicine can be as broad or as narrow as suits the resident’s interests. One of my goals was to become more comfortable initiating and managing gender affirming therapy for gender diverse patients as well as inserting long acting reversible contraceptives in younger patients, which I was able to accomplish by spending time in the gender and sexual health specialty clinic at Hasbro. I was also exposed to college health at Brown University Health Services, the on-campus health center that cares for the undergraduate, graduate, and medical students at Brown University. Other available opportunities include spending time in the general adolescent primary care clinic, the eating disorders specialty clinic, and the Teen-Tot clinic. Residents may also choose to spend time on the inpatient medical-psychiatric floor for children and adolescents at Hasbro Children’s Hospital, as well.
Palliative Care is an approach to improve the quality of life of patients and families who are facing life threatening illness, with a focus on prevention and relief of suffering. Working with Dr. Christine Nevins-Herbert – a graduate of our Family Medicine Program – on the palliative care elective, I was able to gain more insight into the variety of approaches that are used to achieve this goal in multiple inpatient settings. Working with the palliative care team at The Miriam Hospital, a variety of consults were requested throughout the hospital. We spoke with patients and their families about their medical courses, clearing questions that had not yet been answered in a way they could understand. We help lead family meetings and to coordinate care within the various medical specialties involved in each case. We helped transition patients whose desire was to seek end of life care through hospice, when it was medically appropriate, and helped to coordinate this either through home hospice services or through Hope Hospice Inpatient Medical Unit. Working with Dr. Nevins-Herbert at Hope Hospice then gave me insight into end of life care in an inpatient hospice unit. Caring for patients in this stage was challenging but truly rewarding, as families were able to let their loved one’s pass in the peaceful way they had envisioned. Meeting with the chaplain, social workers and nurses who are an integral part of the Hope Hospice Team allowed me to learn each vital role in providing such wonderful care in these critical moments. Through this experience, I gained more confidence in broaching the subjects of palliative care and hospice with my own patients, with the goal of enhancing quality of life and relief of their suffering as they approach challenging medical situations.