WR2 Curriculum

Family Medicine 3rd Year Clerkship

Cleveland Clinic Lerner College of Medicine of Case Western University

LEARNING OBJECTIVES

OVERALL OBJECTIVES  ▪  FAMILY MEDICINE ACTIVITIES

Overall Objectives:

The Family Medicine 3rd year clerkship will be an integrated experience (Block I) along with Internal Medicine and Surgery. The Block will be 16 weeks in length and each student will have a 3 week Family Medicine experience during the Block. Each student will be assigned a primary preceptor at one of the Cleveland Clinic Family Health Centers (east or west side of Cleveland).

The Family Medicine clerkship is a unique experience for the student as he/she will work directly with an attending physician for 3 weeks, enabling the student to gain experience in developing the assessment and plan of patients of all ages. Three major objectives of this experience include:

1. Enhancing history taking, physical exam, and oral presentation skills

2. Performing comprehensive physical exams (CPEs) on children and adults

3. Assessing the undifferentiated patient with common problems encountered in primary care

Contacts for the Rotation:

Ms. Gwendolyn Dove – Clerkship Coordinator
Phone # 216-445-7439

Dr. Kendalle Cobb – Discipline leader
Phone # 440-519-6810
Pager: 26025
Email: cobbk@ccf.org

Dr. Daniel Neides – Block I Chair
Phone # 440-519-6849
Pager: 25519
Email: neidesd@ccf.org

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Family Medicine Activities:

1. The discipline of Family Medicine
    

   1. Diagnosis and treatment of common problems encountered in the outpatient setting

   2. Enhancement of procedural skills

   3. Continuity of care to patients and families

   4. Introduction to issues involving patient care

• Apply the principles of health promotion, disease prevention, and patient education

• Describing ethical dilemmas that confront the family doctor and how to deal with them

• Understand the impact medical costs have on patient care (including medication) which can effect compliance

• Demonstrate professionalism in the outpatient setting

• Demonstrate an appreciation of the doctor-patient relationship encountered in Family Medicine

2. Location of the Family Medicine experience - Students will be assigned to a Family Medicine preceptor at one of the CCF Family Health Centers
    

   1. Solon

   2. Beachwood

   3. Fairview (Family Medicine Residency)

   4. Independence

   5. Strongsville

   6. Brunswick

   7. Westlake

   8. Willoughby Hills

3. Student Responsibilities
    

   1. The clerkship is student centered and will require an “honor system” in order for the rotation to be successful. 

   2. Students will be responsible to attend clinic with the assigned preceptor Monday thru Thursday during the 3 week clerkship. Fridays are reserved for didactics and other course responsibilities at the Lerner College of Medicine and all students are excused from clinic each Friday.

   3. Students will also be excused from family medicine clinic for the following reasons: attend a surgery for one of their longitudinal surgery patients, round on a post-op surgical patient, or attend an outpatient follow up visit for a post-op surgical patient. 

   4. Students will be trained to use EpicCare (electronic medical record) and are expected to write SOAP notes in the chart, which are to be reviewed and co-signed by the preceptor.

   5. Students will be expected to fill out patient logs to be used as evidence that they are meeting the goals and objectives of Block I. These logs will be used as evidence in their portfolio and for review with the Discipline Assessment Team (DAT) and the student’s Clinical Advisor

   6. Call and Weekends: There will be NO call during the FM clerkship. Students WILL be expected to work 2 Saturdays (8:00am – Noon) during the FM clerkship.

   7. Students will be expected to demonstrate Knowledge, Skills, and Attitude in the evaluation and management of the following (but not limited to) symptoms and diagnoses:

   • Abdominal pain
   • Anemia
   • Asthma
   • Back and joint pain
   • Cancer screening
   • Chest pain
   • Coronary artery disease
   • Congestive heart failure
   • Chronic obstructive pulmonary disease
   • Diabetes
   • Dyspnea and cough
   • Dysuria
   • Gastro-esophageal reflux disease
   • Hematuria
   • Hyperlipidemia
   • Hypertension
   • Men’s health issues (prostate disease, erectile dysfunction)
   • Obesity
   • Rectal bleeding
   • Thyroid disease
   • Upper and lower respiratory tract disease
   • Women’s health issues (menstrual disorders, menopause, osteoporosis)

   
   
4. Preceptor Responsibilities
    

1. Preceptors will be required to attend Faculty Development prior to precepting students in this new Block I format

2. Each preceptor will be responsible for overseeing the student’s progress during the 3 week clerkship

3. Templates will be arranged so that 1-2 patients per half-day session will be directly observed by the preceptor

4. Feedback in the Ask-Tell-Ask format will be expected with each patient encounter

5. Patient logs will be reviewed by the preceptor and written feedback will be provided prior to the student’s meeting with the DAT and the clinical advisor

6. Student evaluations will be completed prior to the conclusion of the 16 week Block and reviewed by the DAT and Clinical Advisor

5. Friday Conferences – students will be required to attend all Friday conferences scheduled during the Block
    

   1. Science of Assessment and Reflection – Friday mornings 7:00-8:00 am

   2. Basic Science and Clinical Science Rounds – Friday mornings
      8:00-11:00 am

6. Assessment

1. The DAT will oversee the student’s portfolio and ensure that the student is getting an adequate exposure to the symptoms and diagnoses (as outlined in section 3. f.)

2.  Assessment will be based on patient logs, basic science/clinical science presentations, oral presentation reviews, simulation center exercises, etc…) as entered into the portfolio

3. The DAT will also have the responsibility of determining that each student is meeting the goals and objectives of the nine competencies (Research, Knowledge, Communication, Clinical skills, Clinical reasoning, Professionalism, Personal development, Health care systems, Reflective practice) as outlined by the CCLCM assessment committee

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