Family Medicine Clerkship

The Family Medicine Clerkship is a 6-week clerkship experience, in which students spend their time in an ambulatory clinic setting caring for patients ranging from the newborn to geriatric population.  Students, in working with family medicine physicians, will take histories, perform physical examinations and counsel patients on a myriad of common chronic medical problems such as diabetes, hypertension and depression.  Students will also provide care for acute medical issues and counsel patients on preventive care.  Finally, students will engage in didactic experiences, ranging from lectures, small groups and team-based learning on issues important to Family Medicine. 

Assessment Methods Grade Composition
Written Clinical Evaluations 45%
Didactic Session Performance 15%
SACC Project 15%
Final Exam 25%
Objectives
1. Gather accurate and thorough histories from a patients presenting for common presentations in ambulatory family medicine.
2. Perform a focused, pertinent physical exam for common presentations in ambulatory family medicine.
3. Formulate appropriate differential diagnoses and initial diagnostic and therapeutic plans for patients presenting with acute and chronic conditions in an ambulatory family medicine office.
4. Organize and succinctly summarize information from a patient encounter in an ambulatory family medicine setting in an oral presentation.
5. Organize and succinctly summarize information from a patent encounter in an ambulatory family medicine setting in a progress note.
6. Apply relevant clinical evidence to develop preventive care interventions and acute and chronic disease diagnostic and treatment plans for patients in an ambulatory family medicine setting.
7. Demonstrate advanced patient communication skills regarding the interpretation of tests and guidelines, the pathophysiology of disease and chosen interventions.
8. Reflect on encounters with patients and colleagues to understand role of biases and improve clinical care
9. Describe the critical role of family physicians within any health care system
10. Design a community based intervention addressing the social and community context of a particular health issue affecting the community surrounding an outpatient health center.
11. Describe the indications, contraindications, and complications of common ambulatory procedures and perform the procedures in a simulated environment.
Required Clinical Experiences
Family Medicine Clerkship Experience Log 
The following presentations (and diagnoses) are required to be seen during the rotation. The list is long, but should be easily attained over the six weeks. Please note that virtual patient cases also count towards these minimum requirements. Therefore, if you are at a site that has fewer children (for example), you should be sure to complete three Aquifer Family Medicine cases that are well child checks in order to meet this requirement. In combination with the Aquifer cases, you should be able to meet these requirements at any site over a six-week period. 
Checklist Item: Min # of Times: Comments/Aquifer Cases:
Evaluate/help manage abdominal pain 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

AqFM 15, 19, 20

Evaluate/help manage abnormal vaginal bleeding 1

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

menorrhagia, menometrorrhagia, post-menopausal bleeding; AqFM 17

Perform an adult health maintenance exam 2

Type of Patient: Simulated, Real

Student Responsibility: Perform

Setting: Outpatient

AqFM 1, 2

Evaluate/help manage anxiety 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

GAD, panic disorder, OCD, etc.; AqFM 9

Evaluate/help manage asthma 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Stable or in exacerbation; AqFM 13, AqPeds 13

Evaluate/help manage back pain 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Acute or chronic; AqFM 10

Evaluate/help manage chest pain 1

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Anginal pain or non-cardiac chest pain; AqIM 02

Evaluate/help manage congestive heart failure 1

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Stable or in exacerbation. AqFM 31

Evaluate/help manage COPD 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Stable or in exacerbation. AqFM 28

Evaluate/help manage depression 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

New presentation or ongoing management. AqFM 3

Evaluate/help manage diabetes mellitus 4

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Type 1, 2 or other. AqFM 6

Evaluate/help manage fatigue 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Acute or chronic. AqFM 26

Evaluate/help manage gastroesophageal reflux 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

New presentation or chronic management. AqFM 19

Evaluate/help manage headache 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

AqFM 18

Evaluate/help manage hypertension 4

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

New diagnosis or chronic management; AqFM 8

Evaluate/help manage knee pain 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

AqFM 11

Evaluate/help manage lipid management 3

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Calculation of ASCVD risk, consideration of statin therapy or diet therapy; AqFM 2

Obtain a patient history observed by faculty member 1

Type of Patient: Real

Student Responsibility: Perform

Setting: Outpatient

Evaluate/help manage osteoporosis  1

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Diagnosis, screening or management

Perform an examination observed by faculty member 1

Type of Patient: Real

Student Responsibility: Perform

Setting: Outpatient

Evaluate/help manage pharyngitis 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Consideration of Modified Centor Criteria. AqFM 23

Evaluate/help manage pregnancy/prenatal care 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Diagnosing pregnancy, options counseling, prenatal care. AqFM 12, 14, 30

Evaluate/help manage rash (e.g. contact dermatitis, eczema, drug rash) 3

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

AqFM 16

Treat a patient for substance misuse  1

Type of Patient: Simulated, Real

Student Responsibility: Perform

Setting: Outpatient

AA, QuitWorks, detox, Suboxone, nicotine replacement

Screen a patient for substance misuse 3

Type of Patient: Simulated, Real

Student Responsibility: Perform

Setting: Outpatient

Taking social history involving substance use, AUDIT-C, CAGE, SASQ

Evaluate/help manage shoulder pain 1

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

AqFM 25

Evaluate/help manage skin cancer or precancerous lesion 1

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Skin Biopsy of suspicious lesion, Aktinic Keratosis, etc. AqFM  16

Evaluate/help manage a sleep problem 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Insomnia, OSA, etc. AqFM 3

Evaluate/help manage smoking cessation counseling 2

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Appropriate counseling for any stage of change. Pharmacologic management. AqFM 2

Evaluate/help manage thyroid disorder 1

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Hyper- or hypothyroid. AqFM 5

Evaluate/help manage upper respiratory infection, not pharyngitis 3

Type of Patient: Simulated, Real

Student Responsibility: Evaluate/Help manage

Setting: Outpatient

Common cold, flu, bronchitis, sinusitis, OM, etc. AqFM 33

Perform a well-child check 2

Type of Patient: Simulated, Real

Student Responsibility: Perform

Setting: Outpatient

AqFM 23, AqPeds 2,3,4