Doctor of Medicine: Clinical Applications Class of 2018 Clerkships

FMED 8110 Family and Community Medicine
Credits:
8
Directors:
VanDerKolk
Grading:
Honors/Pass/Fail
Description:

The Family and Community Medicine Year 3 Clerkship is designed to introduce students to the depth and breadth of family medicine, and the critical role it plays in the delivery of health care in the United States.  Students will be exposed to a wide variety of material, some seen in other clerkships and rotations, but in the context of the core overriding principle of family medicine, continuity of care.

In the pre-week, students will be exposed to preventive care and screening tests in addition to health topics and medical procedures frequently encountered in an outpatient family medicine office.  By the end of the week, students will be able to confidently address routine health maintenance visits and many common outpatient conditions.

The clinical weeks will be spent in a single family medicine office, giving the students the opportunity to experience the breadth of diagnoses and visit types seen in family medicine in addition to continuity of care.  Individual learning topics and case assignments will guide students through several areas of study during the rotation.

The post-week is designed to review and synthesize the core concepts learned throughout the rotation in order to successfully complete the NBME Shelf Exam and OSCE. It will also provide students with time to debrief the rotation and discuss difficult experiences in a non-judgmental environment.

Objectives:
  • Upon completion of the Family and Community Medicine Clerkship the third year student shall be able to:
  • Discuss the principles of family medicine care and the critical role of family physicians within any health care system.
  • Gather information, formulate differential diagnoses, and propose plans for the initial evaluation and management of patients with common presentations.
  • Manage follow-up visits with patients presenting with one or more common chronic diseases.
  • Develop evidence-based health promotion and disease prevention plans for patients of any age or gender including education, risk reduction and health enhancement strategies.
  • Demonstrate competency in advanced elicitation of history, communication, physical examination, and critical thinking skills.
  • Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters.
  • Demonstrate professional behaviors when interacting with patients, families, and all members of the health care team (including physicians and non-physician health professionals).

 

*Adapted from the Society of Teachers of Family Medicine

MED 8110 Medicine
Credits:
8
Directors:
Olken
Grading:
Honors/Pass/Fail
Description:

The 8-week third year Medicine clerkship offers a variety of internal medicine clinical experiences.  Students will be assigned to either Borgess Medical Center or Bronson Methodist Hospital as their "home base" facility.  Students will immerse themselves 
with 1 week of ambulatory internal medicine, 
2 weeks of academic medicine, 1 week of hospitalist medicine, 1 week of nights, and 1 week in a subspecialty (e.g. palliative care, renal, cardiology or infectious disease). During these clerkships students immerse themselves into the clinical environment, taking on specific responsibilities as a valued member of the healthcare team, while being supervised at 
all times.   The WMed third year curriculum includes a number of innovations designed to optimize the students’ experience and provide an excellent foundation for future growth as a clinician. Two of these innovations are the Preparatory Week and the Summary and Assessment Week that flank each six-week clinical experience. The Preparatory Week is designed to optimally prepare the student to excel in the specific clinical setting for the discipline. The Summary and Assessment Week focuses on synthesizing the key knowledge and skills learned during the clerkship and include formative and summative assessments. During both these weeks, one day is dedicated interdisplinary activities in which students from all clerkships join together for a joint educational experience in an overarching topical area.

Objectives:
  • Upon completion of the Internal Medicine Clerkship the third year student shall be able to:
  • Obtain an accurate medical history of an adult patient.
  • Complete an accurate physical examination of an adult patient.
  • Formulate a differential diagnosis and a diagnostic plan from the history and physical findings of an adult patient.
  • Make an oral presentation and write a note after interviewing and examining a patient.
  • Interpret the results and know the indications and risks of common tests for adult patients.
  • Develop appropriate therapeutic plans for active problems in adult patients.
  • Implement appropriate therapeutic plans for active problems in adult patients.
  • Demonstrate the learning skills and ability to identify and meet emerging information needs for diagnosis, prognosis and treatment of adult patients.
  • Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters.
  • Demonstrate skills for coordination of care and communication with colleagues.
  • Demonstrate the knowledge required to provide care for adult patients.
  • Demonstrate effective communication strategies with patients, families, and all members of the health care team (including physicians and non-physician health professionals).
  • Demonstrate professional behaviors when interacting with patients, families, and all members of the health care team (including physicians and non-physician health professionals). 

*Adapted from Yale University School of Medicine’s reduced version of the Clerkship Directors in Internal Medicine/ Society of General Internal Medicine objectives.

OBGY 8110 Women’s Health
Credits:
8
Directors:
McGhee
Grading:
Honors/Pass/Fail
Description:

The Women’s Health Year 3 Clerkship is intended to be a comprehensive, challenging, and rewarding experience addressing essential clinical aspects of obstetrics and gynecology organized in an eight week block.  The Preparatory Week includes a variety of activities to assure success during the subsequent clinical component.  The six-week Clinical Experience affords students a wide range of clinical opportunities to develop the requisite knowledge and skills in Women’s Health.  The final eighth postweek is designed to crystalize principles to accomplish oral and written components for evaluation. 

The following components make up the Clinical Experience:

OB/Gyn Preceptorship – 3 weeks

Maternal & Fetal Medicine (Bronson) –  1 week 
(6 days)

Labor and Delivery (Night Float) –  1 week 
(5 nights)

Gynecologic Surgery –  1 week (5 days)

During the Clinical Experience weeks, students will be expected to complete Independent Study modules covering various topics relating to the particular clinical component.  The Summative and Assessment week is intended to review and synthesize essential clinical concepts, review and assess important clinical skills, and prepare for and successfully complete the NBME Shelf Exam.

Objectives:

Upon completion of the Women's Health Clerkship, the third year student shall be able to:

  • Discuss how women’s reproductive function impacts all of health and disease, including how other diseases impact reproductive function in women.
  • Develop competence in the medical interview and physical examination of women, incorporating ethical, social and diversity perspectives to provide culturally competent health care.
  • Apply recommended prevention strategies to women throughout the lifespan.
  • Explain the normal physiologic changes of pregnancy including interpretation of common diagnostic studies.
  • Describe common problems in obstetrics.
  • Demonstrate knowledge of intrapartum care of the mother and newborn.
  • Demonstrate knowledge of postpartum care.
  • Describe menstrual cycle physiology, discuss puberty and menopause and explain normal and abnormal bleeding.
  • Describe the etiology and evaluation of infertility.
  • Develop in-depth knowledge of contraception, including sterilization and abortion.
  • Demonstrate knowledge of common benign gynecological conditions.
  • Formulate a differential diagnosis of the acute abdomen and chronic pelvic pain.
  • Describe common breast conditions and outline the evaluation of breast complaints.
  • Demonstrate knowledge of perioperative care and familiarity with gynecological procedures.
  • Describe gynecological malignancies including risk factors, signs and symptoms and initial evaluation.
  • Provide a preliminary assessment of patients with sexual concerns.
  • Discuss common ethical issues that arise in the provision of reproductive health care to women.
  • Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters.
  • Demonstrate professional behaviors when interacting with patients, families, and all members of the health care team (including physicians and non-physician health professionals).

 

*Adapted from the Association of Professors of Gynecology and Obstetrics.

PEDS 8110 Pediatric and Adolescent Medicine
Credits:
8
Directors:
K Gibson
Grading:
Honors/Pass/Fail
Description:

The third year Core Pediatric and Adolescent Clerkship will provide the student with broad exposure to both the inpatient and ambulatory aspects of general pediatric care.  There are four components to the clerkship.

Preparatory Week

We will begin by defining the expectations and reviewing important procedural components and resources that students will be expected to utilize throughout the rotation.  Week one will focus primarily on the Well Child Care, Fluids and Electrolytes, and issues unique to the newborn and adolescent period.  Additional didactic teaching will include orientation to Bronson Children’s Hospital and EPIC, the role of parent and how it effects the doctor/patient relationship in caring for children. 

We will spend time on Thursday developing critical thinking skills and discuss differential diagnosis in the child.

We will utilize CLIPP cases in CBL events and other teaching resources in small group discussions.  

We plan to utilize the Sim Center to practice pediatric technical skills and practice clinical skills with newborn and adolescent cases. 

All students will gather on Tuesday and Wednesday afternoon for plenary sessions involving the entire third year class. 

Three weeks of Ambulatory Pediatrics

Placements are in the community or the WMed General Pediatric Clinic.

Main tasks of the rotation are accomplished through observation of doctor patient, doctor family and doctor staff interactions, and when appropriate, patient and family interviewing and physical examination.  Discussion of cases with the medical students may not always occur at the time of patient care in the private practice setting, but students will have an opportunity to learn through teaching that is directed to the patients and their caregivers.

Goals of the ambulatory component are:

Introduce the learner to the basis for well child care (growth, development, nutrition, safety, anticipatory guidance) and how these tasks change throughout maturation

Introduce the learner to common pediatric illness and disease processes

Utilizes COMSEP’s national pediatric third year curriculum

Content is supplemented by CLIPP cases and independent learning

Three weeks of Inpatient Pediatrics

One week of inpatient pediatrics days (7a-6p).

One week of inpatient evenings (2p-midnight).

One weekend inpatient call day (7 am – 6 pm, Saturday or Sunday of inpatient days week).

One week of caring for the newborn – this experience will include the following elements:   

Time spent on the mother baby unit involved in patient care during the daytime (3 days)

Time spent on night call, working with the supervising resident. (2 nights) 
 Goals of the inpatient component are as follow:

Introduce the learner to common conditions and how to recognize when inpatient care is required.

Instruct the learner on the transition from fetus to newborn and normal infant physiology.

Enhance development of differential diagnostic skills.

Improve history taking and physical examination skills.

Familiarize the learner with working as part of a healthcare team.

Provide knowledge of what is required for safe discharge from the inpatient setting.

Utilize COMSEP national pediatric third year curriculum.

Content is supplemented by CLIPP cases and independent learning.

Synthesis and Assessment Week

The week will begin with OSCE assessments on Monday morning.

Consolidation of diagnostic and management skills and relate pediatric clinical content to basic science principles.  Methods may include CLIPP cases, CBL format and/or case reviews focusing on management of common pediatric illnesses.

All students gather on Tuesday and Wednesday afternoon for Plenary sessions.

Summative cognitive assessment, NBME Pediatric Shelf Test, on Friday afternoon, beginning at 1 pm.

Objectives:
  • By completion of the Pediatric and Adolescent Medicine Clerkship the third year student will:

    • Demonstrate knowledge of growth and development (physical, physiologic and psychosocial) and of its clinical application from birth through adolescence.
    • Acquire knowledge necessary for diagnosing and initiating management of common pediatric acute and chronic illnesses.
    • Demonstrate an understanding of the approach of pediatricians to the health care of children and adolescents.
    • Demonstrate an understanding of the influence of family, community and society on the child in health and disease.
    • Develop communication skills that facilitate the clinical interaction with children, adolescents and their families and thus ensure complete and accurate data are obtained.
    • Develop competency in the physical examination of infants, children and adolescents.
    • Develop clinical problem-solving skills.
    • Develop and discuss strategies for health promotion as well as disease and injury prevention, including but not limited to the role of immunizations in prevention.
    • Develop attitudes and professional behaviors appropriate for clinical practice.
    • Discuss management strategies for common pediatric diseases.
    • Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters.
    • Demonstrate professional behaviors when interacting with patients, families, and all members of the health care team (including physicians and non-physician health professionals)

    *Adapted from the Council On Medical Student Education in Pediatrics.

PSYC 8110 Psychiatry and Neurology
Credits:
8
Directors:
Longstreet, Crooks
Grading:
Honors/Pass/Fail
Description:

The goals of the third year medical student clerkship in Psychiatry is designed to provide the student with a broad clinical experience. 
The students will participate in clinical experiences in the inpatient unit at Borgess 
and the outpatient PTSD clinic at the Battle Creek VA.

Objectives:
  • The Neurology portion of the clerkship is designed to provide the students with clinical experiences in Neurology in inpatient and outpatient venues.

    1. Neurology:
    Upon completion of the Neurology component of the Psychiatry/Neurology Clerkship the third year student shall be able to:

  • Examine patients with altered level of consciousness or abnormal mental status and identify grossly abnormal findings.
  • Deliver a clear, concise, and thorough oral presentation of a neurologic patient’s history and examination.
  • Prepare a clear, concise, and thorough written presentation of a neurologic patient’s history and examination.
  • Perform a lumbar puncture on a task trainer demonstrating proper aseptic and procedural technique.
  • Recognize symptoms that may signify neurologic disease (including disturbances of consciousness, cognition, language, vision, hearing, equilibrium, motor function, somatic sensation, and autonomic function).
  • Distinguish normal from abnormal findings on a neurologic examination.
  • Localize the likely site or sites in the nervous system where a lesion could produce a patient’s symptoms and signs.
  • Formulate a differential diagnosis based on lesion localization, time course, and relevant historical and demographic features.
  • Discuss the use and interpretation of common tests used in diagnosing neurologic disease.
  • Demonstrate awareness of the principles underlying a systematic approach to the management of common neurologic diseases (including the recognition and management of situations that are potential emergencies, including, but not limited to stroke, seizures, and meningitis).
  • Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters.
  • Demonstrate professional behaviors when interacting with patients, families, and all members of the health care team (including physicians and non-physician health professionals).

*Adapted from the Association of Directors of Medical Student Education in Psychiatry.*Adapted  from  the American  Academy  of  Neurology,  Association  of  University Professors of Neurology, and American Neurological Association.

2.Psychiatry

Upon completion of the Psychiatry component of the Psychiatry/Neurology Clerkship the third year student shall be able to:

Conduct a complete psychiatric history and examination. Recognize the importance of historical data from multiple sources including family members, healthcare providers, spiritual leaders, old records, child’s teachers, indigenous and complementary providers, etc. Interpret historical data obtained from multiple, relevant sources. Discuss signs and symptoms of psychiatric disorders. Perform the components of the comprehensive Mental Status Examination. Describe common abnormalities, including their causes, for each component of the Mental Status Exam. Perform common screening exams for common psychiatric disorders. Discuss assessing patients who may be at risk for harm to themselves or others. Demonstrate an effective repertoire of interviewing skills including engaging and putting patients at ease, and avoiding common pitfalls. Provide appropriate follow up on patient's clinical progress. Discuss the common methods of various psychotherapies. Discuss common therapeutics, including the indications, contraindications, basic mechanism of action, and side effects of psychotropic medications. Discuss ethical principles in the care of psychiatric patients including respect for patient's autonomy and confidentiality. Discuss relevant legal  issues such as capacity evaluation, civil commitment and the process of obtaining voluntary and involuntary treatment. Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters. Demonstrate professional behaviors when interacting with patients, families, and all members of the health care team (including physicians and non-physician health professionals).

SURG 8110 Surgery
Credits:
8
Directors:
Miller
Grading:
Honors/Pass/Fail
Description:

The third year core surgery clerkship will expose students to a variety of surgical experiences. The students will be assigned to the resident services at Bronson Methodist Hospital or Borgess Medical Center. They will have a preceptor that will mentor them and where the student will gain outpatient experience. They will be exposed to a variety of general surgery inpatient procedures and patients. The student will spend one week on night float to learn about management of emergent surgical diseases. 

The students will be expected to attend academic surgical conferences and will have assigned readings. The summative evaluation will be composed of direct clinical observations by preceptors, oral examinations, a standardized patient and a bioskills portion. Upon the completion of the clerkship students should have a basic knowledge of many common surgical diseases and be comfortable knowing which patients need referral to a surgeon. The students should also be comfortable with sterile technique and basic suturing.

Objectives:

Upon completion of the Surgery Clerkship the third year student shall be able to:

  • Acquire History and Physical Exam skills, which lead to accurate assessment and planning of Surgical Care.
  • Demonstrate competent skill in basic surgical techniques knowing the proper application of those skills.
  • Describe common disease processes in standard treatments that include common core surgical considerations.
  • Develop knowledge, skills, attitudes and behaviors toward learning, which perpetuate lifelong learning, inquisitiveness and evidence-based practice.
  • Communicate with peers, mentors and allied health care personnel in an effective and professional manner.
  • Collaborate with peers, mentors and allied health care personnel in an effective and professional manner.
  • Describe typical postoperative care, including common complications of common core procedures.
  • Discuss the roles of medical students on the Surgery Clerkship and the role of Surgeons in health care delivery.
  • Demonstrate behaviors consistent with the highest standards of professionalism and medical ethics in all patient encounters.
  • Demonstrate professional behaviors when interacting with patients, families, and all members of the health care team (including physicians and non-physician health professionals).

 

*Adapted from the University of Kansas School of Medicine’s reduced version of the Association for Surgical Education’s objectives.