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CHICAGO MEDICAL SCHOOL
____________________________________________________
Family Medicine/Primary Care
MFPM701
SYLLABUS
2018-2019 ACADEMIC YEAR
Education Director: Stuart Goldman, MD
Clinical Education Specialist: Tonya Dixon, RN, MSN, MBA, MPH, EdD (c)
Undergraduate Medical Education Specialist: Marissa McCarthy
[email protected] 847-578-3338 RWCLC 1.090
CLERKSHIP DESCRIPTION The 3rd Year Family Medicine/Primary Care Clerkship is a 6-week rotation that is conducted at a variety of sites including six affiliated hospitals: Adventist Hinsdale, Advocate Christ, Advocate Lutheran General, Presence St. Mary & Elizabeth Medical Center, Presence Resurrection Medical Center and Billings Clinic (Billings, MT) as well as many private practice offices. The rotation is primarily outpatient. The curriculum covers core topics in Family Medicine. In addition to several projects, there are 14.5 hours (over 6 weeks) of mandatory workshops/group learning activities, Motivational Interviewing Instruction and practice workshop followed later in the clerkship with a 4-hour Motivational Interviewing OSCE with standardized patients, a 7-hour Patient Safety Day including standardized patient encounters, a simulation lab learning experience, practice with physical exam, clinical reasoning and performance of therapeutic procedure using patient safety protocols for procedures. Students document their activities by maintaining a log of the patients they see, attending required didactic workshops, and completing assignments. Feedback is given by the Family Medicine Education Director, and by supervising physicians at each site. Students complete a FM/PC Mid-Rotation Feedback form which is reviewed with a supervising physician in which each student reflects on one's own practice of medicine, and seeks and receives feedback. Students demonstrate competence in reading basic EKGs by successfully passing an online EKG quiz. A final exam (online Aquifer Family Medicine Exam) is given at the end of the rotation. CLERKSHIP OBJECTIVES
1. Perform medical, diagnostic and surgical procedures essential for the family medical area of practice within the clerkship. (1.1) 2. Perform reliable history and physical examinations by gathering essential and accurate patient information in addition to the
physical examination, interpreting laboratory data and other tests results. (1.2, 1.4) 3. Develop, organize and carry out patient management plans that are safe and effective at promoting health. (1.3, 1.6, 1.8, 1.9) 4. Demonstrate informed decision making using current technology to search for, evaluate and apply biomedical information and
evidence in the care of patients. (1.5, 2.1, 2.3, 3.6, 3.7, 3.10) 5. Demonstrate interpersonal communication skills with patients, families, peers and other healthcare professionals through effective
listening and written practices that support a team approach for the promotion and maintenance of health and the education of patients and their families. (1.7, 3.8, 4.1, 4.2, 4.3, 4.5, 4.6, 4.7, 7.3)
6. Describe the normal and abnormal bio-physical and clinical scientific principles underlying mechanisms and methods of diagnostic and therapeutic decision-making and clinical problem-solving of care in emergent and non-urgent family medicine cases. (2.2, 2.3)
7. Describe epidemiological and social-behavioral scientific principles underlying the identification of health problems, risk factors, preventative and health promotion strategies and cultural influences impacting patients and populations in emergent and non-urgent family medicine cases. (2.4, 2.5, 3.9)
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8. Identify one’s own strengths, limitations, biases, learning needs, and vulnerabilities to improve oneself and positively impact patient care through self-reflection and seeking feedback from others. (3.1, 3.2, 3.3, 3.5, 8.1)
9. Demonstrate respect, compassion, integrity and ethical decision-making in patient care. (4.6, 4.7, 5.1, 5.3, 7.1) 10. Demonstrate costs awareness and risk-benefit analysis in the care of family medicine patients.(6.3) 11. Identify system error failures and interprofessional strategies used in family medicine to improve patient safety, minimize error and
contribute to continuous quality improvement. (6.5) 12. Identify one’s own role on the team and how it relates to other members of the healthcare team to advance the health of patients
and populations served. (7.2) 13. Identify uncertainty in clinical situations and problem-solve to respond appropriately. (8.8)
Reference D2L for COMPETENCY MAP CLERKSHIP-SPECIFIC PERFORMANCES, PROJECTS, REQUIREMENTS
1. Controversies in Family Medicine at orientation: each of the four groups will address four different clinical prevention topics and submit a summary of their evidence to the D2L “Evidence-Based Medicine (EBM)” Dropbox by the end of the session. This information will be shared for all students on the clerkship block.
2. History & Physical Note (submit a satisfactory full H&P note to the appropriate D2L Dropbox by Friday of week 2) - If the note is unsatisfactory, it must be revised and resubmitted until it is passed.
3. S.O.A.P. Note (submit a satisfactory SOAP note to the appropriate D2L Dropbox by Friday of week 2)
- If the note is unsatisfactory, it must be revised and resubmitted until it is passed.
4. Submit completed FM/PC Mid-Rotation Feedback form (to be uploaded to D2L by Friday of week 3)
5. Patient log- each student must log the required patient encounters on the patient log. • The Patient Logs must be completed by Friday of week 5. • In the Patient Logs, you will document that you have seen one patient in each of the 25 minimum categories of patient
encounters. At least one of those encounters must include a patient who is 65 years of age or older. • It is expected that if students are unable to complete the required encounters that the student will complete the
corresponding alternative Aquifer Family Medicine case(s) or other alternative activity.
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• *Note: The alternative activity must be completed by Friday of the 5th week of the clerkship. • They will be monitored for completion & a report noting successful completion will be available via Aquifer Family Medicine
if cases are done. When written papers are completed as an alternative activity, it will be uploaded to D2L “Alternative Assignments” Dropbox and the Education Director will provide individual feedback to student to confirm appropriate learning has occurred.
• Students are to log ONE (1) case for Geriatric (patient must be 65 years of age or older).
6. EKG Competency Quiz (on D2L) to be completed by Friday of week 4. Must retake quiz until passed. Review with Education Director until successfully able to obtain passing score on quiz.
7. Achievement of Objectives Form: to be signed by Faculty Preceptor(s) and uploaded to appropriate D2L Dropbox the day of the final exam.
8. Procedures and Interaction with Non-Physician Form: to be signed by non-physician interprofessional team member and uploaded to the appropriate D2L Dropbox the day of the final exam.
REQUIRED PATIENT ENCOUNTERS
*At least 1 Encounter must include a patient age 65 years or older & must be documented as Geriatric on One45*
Type of Patient/
Clinical Condition
# to Log
Clinical Setting O
utpatient (OP)
Level of Student Responsibility
Benchmark/Explanation
*Partial Participation (PP) = Participate in 3+ components
*Full Participation (FP) = Participate in 5+ components including one core component of preventive care or health promotion.
Alternative & Suggested Aquifer Family Medicine cases
1. Pediatric wellness visits 1 OP PP or FP Student will:
• Describe the core components of child preventive care – health history, physical examination, immunizations, screening/diagnostic tests, and anticipatory guidance
1. Family/Social support 2. Growth and development (1.1)
If not completed by the midpoint of the clerkship, student will write a one-page paper on a pediatric wellness visit and/or complete one or more of Aquifer Family Medicine cases # 23, 24, 27, 36, 37, 38, 40
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3. hearing 4. lead exposure 5. nutritional deficiency 6. potential for injury 7. sexual activity 8. substance abuse 9. TB 10. Vision
• Identify health risks, including accidental and non-accidental injuries and abuse or neglect. (2.1)
• Conduct a physical examination on a child. (2.2) • Identify developmental stages and detect deviations from
anticipated growth and developmental levels. • Recognize normal and abnormal physical findings in the
various age groups. • Find and apply the current guidelines for immunizations and
be able to order them as indicated, including protocols to “catch-up” a patient with incomplete prior immunizations.
• Identify and perform recommended age-appropriate screenings.
• Provide anticipatory guidelines based on developmental stage and health risks.
• Communicate effectively with children, teens, and families.
2. Adult prevention issues, including screening
1 OP FP Students should be able to:
• Define wellness as a concept that is more than “not being sick.”
• Define primary, secondary, and tertiary prevention. • Identify risks for specific illnesses that affect screening and
treatment strategies. • For women: elicit a full menstrual, gynecological, and
obstetric history. • For men: identify issues and risks related to sexual function
and prostate health. • Apply the stages of change model and use motivational
interviewing to encourage lifestyle changes to support wellness (weight loss, smoking cessation, safe sexual practices, exercise, activity, nutrition, diet.)
• Provide counseling related to health promotion and disease
If not completed by the midpoint of the clerkship, student will write a one-page paper on adult prevention issue(s), including one screening test and/or complete one or more of Aquifer Family Medicine cases # 1, 2, 11, 17, 20, 26
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prevention. • Discuss an evidence-based, stepwise approach to
counseling for tobacco cessation. • Find and apply the current guidelines for adult
immunizations. • For each core health promotion condition below, discuss
who should be screened and methods of screening. • Develop a health promotion plan for a patient of any age or
either gender that addresses core health promotion conditions:
1. breast cancer 2. cervical cancer 3. colon cancer 4. coronary artery disease 5. depression 6. fall risk in elderly persons 7. intimate partner and family violence 8. obesity 9. osteoporosis 10. prostate cancer 11. sexually transmitted infection 12. substance use/abuse 13. type 2 diabetes mellitus
*At least 1 Encounter must include a patient age 65 years or older & must be documented as Geriatric on One45*
For Chronic Diseases (listed below) Management*
Student should be able to:
• Find and apply diagnostic criteria. • Find and apply surveillance strategies. • Elicit a focused history that includes information about adherence, self- management, and barriers to care. • Perform a focused physical examination that includes identification of complications. • Assess improvement or progression of the chronic disease. • Describe major treatment modalities. • Propose an evidence-based management plan that includes pharmacologic and non-pharmacologic treatments and appropriate surveillance and tertiary prevention. • Communicate appropriately with other health professionals (e.g. physical therapists, nutritionists, counselors). (PR, SBP)
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• Document a chronic care visit. • Communicate respectfully with patients who do not fully adhere to their treatment plan. (PR) • Educate a patient about an aspect of his/her disease respectfully, using language that the patient understands. When appropriate, ask the patient to explain any new
understanding gained during the discussion. (PR) *FP = Full Participation in Chronic Disease Management: Participate in at least 5 components above & at least 1 “Presentation Specific Benchmark” component.
Type of Patient/Clinical Condition
# to log
Clinical Setting O
utpatient (OP)
Level of Student Responsibility*
Presentation Specific Benchmark/Explanation
*FP = Full Participation in Chronic Disease Management: Participate in at least 5 components above & at least 1 “Presentation Specific Benchmark” component.
Alternative & Suggested Aquifer Family Medicine cases
CHRONIC DISEASE
3. Multiple Chronic Disease -
(Assess status of multiple diseases, learn to prioritize next steps, document)
1
OP
FP
Student should be able to:
• Assess status of multiple diseases in a single visit. • List important criteria to consider when prioritizing next
steps for management of patients with multiple uncontrolled chronic diseases.
• Document an encounter with a patient who has multiple chronic diseases in an organized way.
If not completed by the midpoint of the clerkship, student will write a one-page paper on managing patient(s) with multiple chronic diseases and/or complete one or more of Aquifer Family Medicine cases # 5, 6, 7, 8, 31, 34
4. Cardiology Chronic
*Hypertension (HTN) *Hyperlipidemia *Coronary Artery Disease (CAD) *Congestive Heart Failure (CHF)
1
OP
FP
Student should be able to:
HTN • Take accurate manual BP. • Recognize signs/symptoms of end) organ disease. Hyperlipidemia • Interpret and determine goals of treatment. CAD • Identify risk factors. • Calculate risk and counsel on strategies to reduce risk. CHF • List underlying causes. • Recognize signs and symptoms of CHF.
If not completed by the midpoint of the clerkship, student will write a one-page paper on managing patient(s) with a chronic cardiac condition and/or complete one or more of Aquifer Family Medicine cases # 2, 6, 8, 9, 14, 21, 28, 31, 34, 35
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5. Obesity 1
OP
FP
Student should be able to:
• Obtain a dietary history. • Collaborate with a patient to set a specific and appropriate
weight loss goal.
If not completed by the midpoint of the clerkship, student will write a one-page paper on assessing and managing patients with obesity and/or complete one or more of Aquifer Family Medicine cases # 1, 2, 7, 21, 35, 40
6. Type 2 Diabetes Mellitus 1
OP
FP
Student should be able to:
• Perform a diabetic foot examination. • Document an encounter using a diabetes mellitus flow
sheet or template. • Recognize the signs/symptoms associated with
hypoglycemia or hyperglycemia
If not completed by the midpoint of the clerkship, student will write a one-page paper on chronic management of patients with Type II Diabetes Mellitus and/or complete one or more of Aquifer Family Medicine cases # 2, 6, 7, 35
7. Asthma/COPD 1
OP
FP
Student should be able to:
• Discuss the difference between asthma and COPD, including pathophysiology, clinical findings, and treatments.
• Elicit environmental factors contributing to the disease process.
• Recognize an obstructive pattern on pulmonary function tests.
• Recognize hyperinflation on a chest radiograph. • Discuss smoking cessation.
If not completed by the midpoint of the clerkship, student will write a one-page paper on chronic management of patients with asthma/COPD and/or complete one or more of Aquifer Family Medicine cases # 13, 28, 29
8. Osteoporosis/ Osteopenia, Osteoarthritis,
Chronic Low Back Pain
1
OP
FP
Student should be able to:
• Obtain a medication use history. • Anticipate the risk of narcotic-related adverse outcomes. • Guide a patient in setting goals for pain control and
function.
If not completed by the midpoint of the clerkship, student will write a one-page paper on the diagnosis and management of osteoporosis/osteopenia or complete Aquifer Family Medicine cases #1
9. Psychiatry & Substance Abuse
Depression *Initial Presentation *Chronic management
1
OP
FP
Student will:
• Find and apply diagnostic criteria. • Assess improvement or progression of the chronic disease. • Describe major treatment modalities. • Propose an evidence-based management plan that includes
If not completed by the midpoint of the clerkship, student will write a one-page paper on depression, anxiety or substance abuse and/or complete one or more of Aquifer Family Medicine cases # 2, 3, 5
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Anxiety *Chronic management Substance Abuse
pharmacologic and non-pharmacologic treatments and appropriate surveillance and tertiary prevention.
• Educate a patient about an aspect of his/her disease respectfully, using language that the patient understands. When appropriate, ask the patient to explain any new understanding gained during the discussion.
Depression • Appreciate the many presentations of depression in primary
care (e.g. fatigue, pain, vague symptoms, sleep disturbance, and overt depression).
• Use a validated screening tool for depression. • Assess suicidal ideation. • Recognize when diagnostic testing is indicated to exclude
medical conditions that may mimic depression (e.g. hypothyroidism).
• Recognize the role of substance use/abuse in depression and the value of identifying and addressing substance use in depressed patients.
• Recognize the potential effect of depression on self-care and ability to manage complex comorbidities.
Anxiety • Describe how an anxiety disorder can compromise the
ability for self- care, function in society, and coping effectively with other health problems.
Substance Abuse • Obtain an accurate substance use history in a manner that
enhances the student-patient relationship. • Differentiate among substance use, misuse, abuse, and
dependence. • Discuss the typical presentations for withdrawal from
tobacco, alcohol, prescription pain medications, and common street drugs.
• Assess a person’s stage of change in substance use/abuse cessation.
• Communicate respectfully with all patients about their substance abuse.
(*initial presentation), 18, 22, 24, 29, 30, 31 (Depression); 31 (anxiety); 2, 5, 15, 18, 29 (Substance abuse)
*At least 1 case must include a patient age 65 years or older, case must be documented as Geriatric One45 corresponding minimum encounter*
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For All Acute:
Student will:
• Be able to differentiate among common etiologies based on presenting symptom. • Recognize “don’t miss” conditions that may present with symptoms. • Elicit a focused history and perform a focused physical exam. • Describe the initial management of common and dangerous diagnoses that present with symptom. • Discuss the importance of a cost-effective approach to the diagnostic work-up. *Partial Participation (PP) = Participate in at least 2 components above. *Full Participation (FP) in Chronic Disease Management= Participate in at least 4 components above.
Type of Patient/Clinical Condition
# to log
Clinical Setting O
utpatient (OP)
Level of Student Responsibility*
Presentation Specific Benchmark/Explanation Alternative & Suggested Aquifer Family Medicine
cases
10. Headaches
Common Examples: *Tension, *migraine, *sinus pressure headaches Serious: *Meningitis *subarachnoid hemorrhage *temporal arteritis
1 OP PP or FP
Student will:
• Determine when imaging is indicated. Skills: Conduct an appropriate musculoskeletal examination that incudes inspection, palpitation, range of motion, and focused neurologic assessment.
If not completed by the midpoint of the clerkship, student will write a one-page paper on headaches and/or complete Aquifer Family Medicine cases # 18
11. Dizziness
Common Examples: *Benign positional vertigo *labyrinthitis, *orthostatic dizziness Serious:
1
OP
PP or FP
Student will:
• Be able to differentiate among common etiologies based on presenting symptom.
• Recognize “don’t miss” conditions that may present with sx. • Elicit a focused history and perform a focused physical exam. • Describe the initial management of common and dangerous
diagnoses that present with symptom.
If not completed by the midpoint of the clerkship, student will write a one-page paper on dizziness and/or complete either or both Aquifer Family Medicine cases # 22, 33
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*Cerebrovascular disease *brain tumor, *Meniere’s Disease 12. Upper Respiratory Symptoms
Examples: Infections *viral upper respiratory infection *bacterial sinusitis *streptococcal pharyngitis *otitis media *mononucleosis Noninfectious *allergic rhinitis
1
OP
FP
Student will:
• Recognize that most acute upper respiratory symptoms are caused by viruses and are not treated with antibiotics
• Determine a patient’s pretest probability for streptococcal pharyngitis and make appropriate treatment decisions (e.g. empiric treatment vs. test vs. neither treat nor test).
If not completed by the midpoint of the clerkship, student will write a one-page paper on upper respiratory symptoms and/or complete one or more of Aquifer Family Medicine cases # 13, 21, 23, 39
13. Cough
Common Examples: Infections *Pneumonia *Bronchitis *Sinusitis Noninfectious *Asthma *GERD *Allergic Rhinitis Serious: *lung cancer *pneumonia *TB
1
OP
PP or FP
Student will:
• Understand how pretest probability and the likelihood of test results altering treatment can be used to guide diagnostic testing.
Skills: Recognize pneumonia on a chest X-ray.
If not completed by the midpoint of the clerkship, student will write a one-page paper on cough and/or complete one or more of
Aquifer Family Medicine cases # 13, 21, 23, 28, 29, 39
14. Chest Pain
Examples: GI (GERD) MSK (Costochondritis) Cardiac (Angina, MI/ACS)
1
OP
PP or FP
Student will:
• Describe how age and comorbidities affect the relative frequency of common etiologies.
• Apply clinical decision rules that use pretest probability to guide evaluation.
If not completed by the midpoint of the clerkship, student will write a one-page paper on chest pain and/or complete one or more of
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Pulm (PE, pneumothorax)
• Recognize the indications for emergent versus urgent versus non-urgent management for varying etiologies of chest pain.
Skills: Recognize cardiac ischemia and injury on an electrocardiogram (ECG).
Aquifer Family Medicine cases # 2, 31, 34
15. Shortness of Breath / Wheezing
Common Examples: *Asthma, *chronic obstructive pulmonary disease (COPD), *obesity, *angina *congestive heart failure Serious: *Exacerbations of asthma or COPD, *pulmonary embolus, *pulmonary edema, *pneumothorax, *acute coronary syndrome
1
OP
PP or FP
Student:
Skills: Recognize typical radiographic findings of COPD and CHF.
If not completed by the midpoint of the clerkship, student will write a one-page paper on shortness of breath/wheezing and/or complete one or more of Aquifer Family Medicine cases # 5, 13, 28, 34
16. Fever
Common Examples: *Viral upper respiratory syndromes, *streptococcal pharyngitis, *influenza, *otitis media Serious: *fever in the immunosuppressed patient *Meningitis, *sepsis,
1
OP
FP
Student will:
• Describe a focused, cost- effective approach to diagnostic testing.
• Propose prompt follow-up to detect treatable causes of infection that appear after the initial visit.
If not completed by the midpoint of the clerkship, student will write a one-page paper on fever and/or complete one or more of Aquifer Family Medicine cases # 13, 21, 23
17. Abdominal Pain
Common Examples: *Gastro-esophageal reflux disease
1
OP
PP or FP
Student will:
• Recognize the need for emergent versus urgent versus non-urgent management for varying etiologies of abdominal pain.
If not completed by the midpoint of the clerkship, student will write a one-page paper on abdominal pain and/or
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(GERD), *gastritis, *gastroenteritis, *irritable bowel syndrome, *dyspepsia, *constipation, *depression Serious: *Appendicitis, *diverticulitis, *cholecystitis, *inflammatory bowel disease, *ectopic pregnancy, *peptic ulcer disease
• Recognize the need for emergent versus urgent versus non-urgent management for varying etiologies of abdominal pain.
complete one or more of Aquifer Family Medicine cases # 15, 19, 20, 32
18. Dysuria
Common examples: *Urethritis, *bacterial cystitis, *pyelonephritis *prostatitis, *vulvovaginal candidiasis
1
OP
FP
Student:
Skills: Interpret a UA.
If not completed by the midpoint of the clerkship, student will write a one-page paper on dysuria and/or complete one or more of Aquifer Family Medicine cases # 4, 14, 15, 29
19. Male Urinary Symptoms
Common examples: *Prostatitis *Benign prostatic hypertrophy Serious: *Prostate Cancer
1
OP
PP or FP Student will:
• Select appropriate laboratory tests for a male patient with urinary complaints.
If not completed by the midpoint of the clerkship, student will write a one-page paper on male urinary symptoms and/or complete one or both Aquifer Family Medicine cases #16, 19
20. Gynecology
*Vaginal Discharge *Abnormal Vaginal Bleeding
1
OP
PP or FP
Student will:
Vaginal Discharge • Discuss the interpretation of wet prep and potassium hydroxide
(KOH) specimens. Vaginal Bleeding • Elicit an accurate menstrual history.
If not completed by the midpoint of the clerkship, student will write a one-page paper on vaginal discharge or vaginal bleeding and/or complete one or more of Aquifer Family Medicine cases #
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• Recognize when vaginal bleeding is abnormal.
12, 14, 17, 20, 32
21. Low Back Pain
Acute Common Examples: *Muscle strain, *altered mechanics including obesity *nerve root compression
Serious: *Aneurysm rupture, *acute fracture infection, *spinal cord compromise, *metastatic disease
1
OP
FP
Student will:
Acute
• Describe indications for plain radiographs in patients with back pain.
If not completed by the midpoint of the clerkship, student will write a one-page paper on low back pain and/or complete Aquifer Family Medicine cases # 10
22. Leg Swelling
Common Examples: *Venus stasis *medication-related edema Serious: *Deep venous thrombosis (DVT), *obstructive sleep apnea, *CHF
1
OP
FP
Student will:
• Recognize the need for urgent versus non-urgent management for varying etiologies of leg swelling, including when a Doppler ultrasound test for DVT is indicated.
If not completed by the midpoint of the clerkship, student will write a one-page paper on leg swelling and/or complete one or both Aquifer Family Medicine cases #7, 31
23. Joint Pain &/or Injury
Acute Common Examples: *Ankle sprains and fractures, *knee ligament and meniscal injuries *shoulder dislocations *rotator cuff injuries, *hip pain, *Carpal Tunnel Syndrome, *osteoarthritis *overuse syndromes: -Achilles’ tendinitis,
1
OP
PP or FP
Student will:
Acute
• Describe the difference between acute and overuse injuries. • Elicit an accurate mechanism of injury. • Perform an appropriate musculoskeletal examination • Apply the Ottawa decision rules to determine when it is
appropriate to order ankle radiographs. Skills: Detect a fracture on standard radiographs and accurately describe displacement, orientation, and location (e.g., non-displaced spiral
If not completed by the midpoint of the clerkship, student will write a one-page paper on joint pain &/or injury and/or complete one or more of Aquifer Family Medicine cases # 4, 11, 25
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-patella-femoral pain syndrome, -subacromial bursitis/rotator cuff tendinosis Serious: *acute vascular compromise associated with a fracture or a dislocation *acute compartment syndrome *Septic arthritis
fracture of the distal fibula).
24. Dementia
1
OP
PP or FP
Student will:
• Perform a screening test for cognitive decline (e.g. the clock drawing test or the Mini-Mental Status Examination).
• Select appropriate initial diagnostic tests for a patient presenting with memory loss, focusing on tests that identify treatable causes.
If not completed by the midpoint of the clerkship, student will write a one-page paper on dementia and/or complete one or both Aquifer Family Medicine cases #3, 29
25. Dermatology
Common Skin Rashes *Atopic dermatitis *contact dermatitis *scabies, *seborrheic dermatitis *urticarial Common Skin Lesions *Actinic keratosis *seborrheic keratosis *keratoacanthoma *melanoma *squamous cell carcinoma *basal cell carcinoma *warts *inclusion cysts
1
OP
FP
Student will:
• Describe a skin lesion using appropriate medical terminology. • Describe the characteristics of the rash. Skills Prepare a skin scraping and identify fungal elements.
If not completed by the midpoint of the clerkship, student will write a one-page paper on a dermatologic condition or complete Aquifer Family Medicine cases #16
REQUIRED AND RECOMMENDED CLERKSHIP MATERIALS
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Required: Patient Safety Day Required Readings (See D2L for list of required readings which will be labelled, “SIM LAB/PATIENT SAFETY WORKSHOP”) Recommended Study Resources (see D2L for complete list): Online:
• Aquifer Family Medicine cases - 40 cases online learning modules (see D2L) • AAFP Editor’s Choice of Best Available Content website (link on D2L)
http://www.aafp.org/afp/topicModules/viewAll.htm Online & Paper Textbooks:
• Symptom to Diagnosis, An Evidence-Based Guide, Lange, 3ed. (available via AccessMedicine through Boxer Library) • Color Atlas of Family Medicine, 2ed. (available via AccessMedicine through Boxer Library)
Additional study books, question books:
• Case Files in Family Medicine, 3e (LANGE Case Files) • Pretest Family Medicine, 3e
Online Practice Questions:
• AAFP Online Board Review Questions (Registration required, free access within a few days); https://nf.aafp.org/account/home/new?target=HTTP://www.aafp.org/cgi-bin/lg.pl?redirect=https://www.aafp.org/home.html
• UWorld questions • USMLE Easy Question Bank (via Boxer Library)
EKG Reading Recommended:
• Textbook: The Only EKG Book You Will Ever Need by Thaler • Practice Clinical Skills: EKG, Heart & Lung Auscultation website (link on D2L); http://www.practicalclinicalskills.com/
Evidence Based Medicine Recommended Review: (see D2L)
• PICO = Formula for Creating Clinical Questions – link (click on “Ask”) • How to Read a Systematic Review and Meta-analysis and Apply the Results to Patient Care: Users’ Guides to Medical Literature (MH
Murad, VM Montori, et. Al. JAMA. 2014; 312(2):171-179)
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Apps: • Preventive medicine and screening; http://epss.ahrq.gov/PDA/index.jsp • Dynamed Plus (through Boxer Library) • AccessMedicine (through Boxer Library) • UpToDate (through Boxer Library)
Motivational Interviewing:
• Introduction to Motivational Interviewing (See D2L) EVALUATION, EXAMINATION, AND REMEDIATION POLICIES Refer to D2L for:
• CMS Excused Absence Policy document for examination and other clinical experience remediation guidelines. • CMS Clerkship Grading Policy • Clinical Evaluation Standards • Required Minimum Patient Encounters are included in the syllabus and indicate specific patient type/clinical condition remediation
guidelines. • CMS Exam Conduct Policy • RFUMS Exam Loaner Laptop Policy • CMS Clerkship Retake/Rescheduled Exam Policy • RFU Remediation Policy
Aquifer Family Medicine Online Final Exam: The Aquifer Family Medicine Online Final Exam is typically held at the RFUMS Campus on the last Friday of the rotation from 9:00 a.m. to 12:00 p.m. However, please refer to D2L for the most recent updates. Aquifer is responsible for grading exams. No challenges are accepted for Aquifer exams. Scores will be available approximately 1-2 weeks after the exam has been completed, but will not be published until clinical evaluations have been received.
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In general, Education Directors will determine how the student will make up patient encounters, clinical activities or other clerkship requirements. Clerkship Directors will determine if and when the student will be required to repeat the clerkship. Clerkship Directors will use case-by- case evaluation and coordinate with the Office of Student Affairs & Education. CMS Remediation Procedures: Eligibility Criteria for Remediation: At the end of the rotation, students who have a failing grade in any of the applicable course components (final exam, clinical evaluation, and/or performances) will be offered remediation for the component(s) they have failed. Process for Remediation: Students are required to take exams, if applicable, as scheduled and in the proscribed manner outlined in the CMS Clerkship Retake/Rescheduled Exam Policy. Clinical evaluations and/or rotation-specific performances requiring remediation will be addressed by the Education Director based upon the deficits. Remediation Grading Outcomes: If the student passes the remediation, they receive a grade of “Pass” for the rotation. If the student fails the remediation, they receive a grade of “Fail” for the rotation. A failure will result in the student repeating all or part of the rotation at the discretion of the Education Director, in consultation with the Assistant Dean of Clinical Education. Maximum number of attempts to remediate: Students will have one retake opportunity to pass a remediation. Please reference the following additional Polices and Guidelines posted to D2L:
• SEPAC Handbook • SEPAC Policy • Clinical Grade Appeal Policy • Clerkship/Sub-Internship Grade Appeal Form • Student Policies Handbook • Testing Accommodations Guidelines • CMS Learner Mistreatment Policy and Procedures • Medical Student Work Hours Policy • Off-Site Secure Storage Policy • Teacher-Learner Expectations • CMS Professionalism Policy and Procedures • CMS Dress Code Policy • Ebola Virus Policy
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• Exposure Incidents Policy • Alcohol and Drug Use Policy
Holiday Schedule: You must follow the holiday schedule for your site, not Chicago Medical School's schedule. Weather Emergencies: If the University is closed due to extreme weather, check with your clinical site regarding its status. Unless otherwise directed by your Site Director, you should go to your clinical site. ACADEMIC ACCOMMODATION Rosalind Franklin University of Medicine and Science is committed to providing equal access to learning opportunities for students with documented disabilities. To ensure access to this class and your program, please contact the ADA Coordinator at 847.578.8354 or [email protected] to engage in a confidential conversation about the process for requesting accommodations in the classroom and clinical settings. Accommodations are not provided retroactively. Students are encouraged to register with the ADA Coordinator as soon as they begin their program. Rosalind Franklin University of Medicine and Science encourages students to access all resources available. More information can be found on the Academic Support InSite page or by contacting the ADA Coordinator. SITE DIRECTORS, FACULTY AND STAFF Adventist Hinsdale Centegra Health System Site Director: Dr. Kate Gunnell Site Director: Dr. Clare Legursky [email protected] [email protected] Site Coordinator: Mary Fehrman Site Coordinator: Edie Best [email protected] [email protected] 630-856-8944 815-759-8151 Advocate Christ Presence Resurrection
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Site Director: Dr. Cynthia Ohata Site Director: Dr. AnnMarie Walsh [email protected] [email protected] Site Coordinator: Jeanette Gooden-Solomon Site Coordinator: Marcia Mallerdino [email protected] [email protected] 708-857-5902 773-792-5155 Advocate Lutheran General Presence St. Mary & Elizabeth Site Director: Dr. Tamar Perlow Site Director: Dr. Stephanie Place [email protected] [email protected] Site Coordinator: Marisol Hernandez-Martinez Site Coordinator: Nadia Kalam [email protected] [email protected] 847-723-6464 312-770-3293 Billings Clinic, MT For private preceptor contact info, please Site Director: Dr. Michael Temporal refer to D2L Content tab “Site Paperwork [email protected] & Reporting” which will link you to the google Site Coordinator: Kristina McComas drive folder. [email protected] 406-238-5059 CLERKSHIP SCHEDULE FOR 2018-2019
1. July 2 to August 10, 2018 • Orientation – July 5, 2018 • Chronic Disease Workshop – July 11, 2018 • Patient Safety Workshop – July 18, 2018 • Lectures at LGH – July 25, 2018 • Motivational Interviewing Workshop at Huntley – August 1, 2018 • Aquifer FM final exam – August 10, 2018
2. August 13 to September 21, 2018
• Orientation – August 15, 2018
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• Lectures at LGH – August 25, 2018 • Chronic Disease Workshop – August 29, 2018 • Patient Safety Workshop – September 5, 2018 • Motivational Interviewing Workshop at Huntley – September 12, 2018 • Aquifer FM final exam – September 21, 2018
3. September 24 to November 2, 2018
• Orientation - September 26, 2018 • Lectures at LGH – October 3, 2018 • Chronic Disease Workshop – October 10, 2018 • Patient Safety Workshop – October 17, 2018 • Motivational Interviewing Workshop at Huntley – October 24, 2018 • Aquifer FM final exam – November 2, 2018
4. November 5 to December 14, 2018
• Orientation – November 7, 2018 • Lectures at LGH – November 21, 2018 • Motivational Interviewing Workshop at Huntley – November 28, 2018 • Chronic Disease Workshop – December 5, 2018 • Patient Safety Workshop – December 12, 2018 • Aquifer FM final exam – December 14, 2018
5. January 7 to February 15, 2019
• Orientation – January 9, 2019 • Chronic Disease Workshop – January 16, 2019 • Patient Safety Workshop – January 23, 2019 • Motivational Interviewing Workshop at Huntley – January 30, 2019 • Lectures at LGH – February 6, 2019 • Aquifer FM final exam – February 15, 2019
6. February 18 to March 29, 2019
• Orientation – February 20, 2019 • Chronic Disease Workshop – February 27, 2019
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• Patient Safety Workshop – March 6, 2019 • Motivational Interviewing Workshop – March 20, 2019 • Lectures at LGH – March 27, 2019 • Aquifer FM final exam – March 29, 2019
7. April 1 to May 10, 2019
• Orientation – April 3, 2019 • Motivational Interviewing Workshop at Huntley – April 10, 2019 • Chronic Disease Workshop – April 17, 2019 • Patient Safety Workshop – April 24, 2019 • Lectures at LGH – May 1, 2019 • Aquifer FM final exam – May 10, 2019
8. May 13 to June 21, 2019
• Orientation – May 15, 2019 • Chronic Disease Workshop – May 22, 2019 • Patient Safety Workshop – May 29, 2019 • Motivational Interviewing Workshop at Huntley – June 5, 2019 • Lectures at LGH – June 19, 2019 • Aquifer FM final exam – June 21, 2019
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