Family Medicine Clerkship

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Welcome to Family Medicine! This four-week block affords students the opportunity to improve basic clinical skills with special attention to the musculoskeletal exam and preventative medicine. You will enjoy working with patients of all ages with diverse backgrounds and medical conditions. This rotation offers the unique opportunity for exclusively one-on-one interaction with a single physician. Schedules average four full clinical days per week. Many students will work outside of the Indianapolis area, allowing those students to witness the full scope of medicine that Family Medicine physicians have the opportunity to provide. You will become familiar with treatment options for common medical conditions such as HTN, diabetes, anxiety, depression, UTI, URI, etc. During your rotation you will have the opportunity to be proactive in forming your own assessments and plans as well as address knowledge gaps by asking questions and learning 'on the job'.

Grading

We follow the standard grading system established for each required rotation of third year.

  • 50% based on clinical evaluations
  • 25% based on Aquifer Family Medicine exam
  • 25% based on assignments
    • 15% Community and Family Project and Breaking Barriers Module
    • 5% Practice Based Learning and Improvement
    • 5% professionalism and timely completion of assignments

How to do well on clincial evaluations:

To succeed in this rotation it is best to be involved and proactive in your patient care. If your preceptor thinks you are interested in helping out and improving your physical exam skills, it is likely you will be allowed to do even more. Pap smears, biopsy, incisions/drainages, and other office procedures are routinely done in family medicine offices---so don’t be afraid to respectfully ask if you can get more hands on experience!

Doing the "obvious" things will usually be enough to receive positive evaluations: ask relevant questions to show your interest and deepen your clinical knowledge, help out when appropriate, be nice to entire clinical staff and all patients, and show up on time!

How to prepare for the final exam:

The final exam for the Family Medicine clerkship is unique from other clerkships in that it is not an NBME, but rather made from Aquifer. To prepare for their exam, Aquifer has 40 clinical cases available for students to work through. These are NOT required, but STRONGLY suggested as the final exam is based on the information provided in these cases. We suggest starting these cases during the first week of the clerkship as they can take anywhere from 20-50 minutes to completed depending on complexity and individual pace.

Midway through the Family Medicine Clerkship, you will have the opportunity to complete an optional practice 25-question online exam using questions from the Aquifer Family Medicine test question bank. This exam will be accessible through Canvas. Within 2 working days of the exam closing, you will receive individual feedback on your results suggesting which of the 40 cases to review in preparation of the final exam. A passing score is above 60%.

Community and Family Project:

The Family and Community Project serves as a capstone event that has been designed to bring together what you have learned during your clerkship while also emphasizing the mission and values of Family Medicine. To successfully complete this project you will need to identify a patient or population that faces barriers to health or health care, interview a practicing health care professional who works with that patient or community, and collaboratively find resources that might help the patient or people group address one or more of those barriers. Specific and detailed information about this project will be given in the syllabus. The project will be uploaded to Canvas and graded by the clerkship faculty rather than your individual preceptor to ensure equal grading standards (a rubric will be provided for you).

Advice: ask your preceptor at the beginning of the rotation to help you identify possible patients who would be willing to speak with you at length about their barriers to healthcare and their family tree. Try not to wait until the last week to complete this project, as it project takes coordination with multiple people and you will want to focus on your upcoming exam during the final week.

Breaking Barriers Module:

Students will complete only 2 out of the 4 modules focused on issues pertaining to medically underserved populations. After completing the first module, Understanding Barriers to Healthcare, students may chose which of the three remaining modules they would like to complete. The modules can be accessed through Canvas and each take approximately 60 minutes each to complete.

Practice Based Learning and Improvement (PBLI):

This is a standard assignment required for all third year electives at IUSM. Complete instructions will be available on Canvas. You will become very familiar with this assingment throughout the year.

Failing grades: A grade of Fail will be reported for students who score less than Pass on the Community Faculty or score less than Pass (60%) on the final exam twice. The first time a student fails the final exam, the student will receive an ID-MK and be required to retake the final exam. The highest final grade for the Family Medicine Clerkship after one failure of the final exam is an ID-MK/Pass.

Additional Assignments

Motivational Interviewing: The Motivational Interviewing module is located on the Family Medicine Clerkship Canvas site. The entire module will take approximately 80 minutes to complete. However the module is broken down into brief learning components. Satisfactory completion of this module is required, based upon the rubric provided in Canvas.

Mid-rotation feedback: This is a standard assignment required for all third year electives at IUSM. Complete instructions will be available on Canvas. You will become very familiar with this assingment throughout the year.

Observed H&P within first 7 days: This is a standard assignment required for all third year electives at IUSM. Complete instructions will be available on Canvas. You will become very familiar with this assingment throughout the year.

Patient encounter tracking: This is a standard assignment required for all third year electives at IUSM. Complete instructions will be available on Canvas. You will become very familiar with this assingment throughout the year. We suggest keeping a piece of paper or small notebook in your white coat to track of each patient's age, gender and chief complaint to record at the end of the day, or week.

Travel and housing

Travel expectations: Students should expect to travel up to 45 minutes from the assigned site to the community faculty office. As well, students traveling to distant cities should plan to report the day before the first day of clerkship.

Travel reimbursement: Travel costs are not reimbursed for the Family Medicine Clerkship.

Housing accommodations: Housing accommodations are provided for Indianapolis-based students assigned outside Indianapolis and surrounding counties. Campus-based students will be provided housing if assigned to a site outside their regional campus area. Housing information will be provided by the program site before the rotation begins. Housing amenities vary by site. Students should inquire at least 2 weeks prior to rotation start regarding site-provided amenities.

Resources

If you are worried the cases will not be enough to fuel your study train, other resources students have liked in the past include:

  • American Board of Family Medicine (ABFM) Exam Prep - An application for your phone with practice questions, documents and videos
  • Case Files Family Medicine

Eugene Toy, Donald Briscoe, Bal Reddy, Bruce Britten

  • Blueprints Family Medicine

Martin S. Lipsky, Mitchell S. King

  • Family Medicine PreTest Self-Assessment and Review

Doug Knutson Some useful clinical resources include:

  • Step-Up to Medicine

You can also use this to study for your medicine rotation.

  • Pocket Medicine (small enough to fit in your white coat pocket)

Helpful apps/websites

  • American Academy of Family Physicians (AAFP). You can google a search topic (i.e., “diabetes guidelines and AAFP”) to find journal articles that will go through pathophysiology, diagnosis, treatment, or anything else you want to know about a topic and how it relates to family practice.
  • Epocrates app
  • MDCalc app
  • Shots by STFM app