SOM Elective Brochure
 

Electives Type:  Clinical

Elective Title
Acting Internship in Family Medicine in Austin
Course Number
FAMU-4150
Duration/Weeks
4
Prerequisites: Successful completion of Year 3 
      Additional Requirements:
C form to tmmcelligott@seton.org . Applicants must submit a statement describing how they intend to utilize the family medicine experience to enhance his/her professional development and list specific objectives the rotation satisfies for this development
Responsible Faculty Director:
David Wright, MD
Other Faculty:
Location to Report on First Day
Contact Tricia M. McElligott at tmmcelligott@seton.org or 512-324-7860
Periods Offered
1-11
including Period 12 (June), including the holiday vacation Period 13 (Dec)
Maximum Enrollment
2

Goals
 1. Enhance student competencies in diagnosing and treating both routine and complicated primary care problems of patients admitted to the Family Medicine inpatient service and Blackstock Prinamry Care Clinic. 2. Understand the role of the family physician working with consultants and community health resources. 3. Develop a basic understanding of family dynamics and family-centered care, particularly in relation to complex and difficult patient problems. 4. Recognize the importance of the interdisciplinary approach to inpatient care. 5. Prepare to function as an intern.

Objectives
 1. Evaluate and propose a management plan for problems of patients commonly admitted to a Family Medicine service. 2. Record for audit by resident and/or attending faculty an admission history and physical exam and SOAP notes for the problems assessed. 3. Provide daily comprehensive hospital management of these patients, under the supervision of third-year residents and Family Medicine faculty. 4. Discuss the pharmacology and cost of drugs commonly utilized in the treatment of inpatients. 5. Identify medical, family, and community resources to assist in the care of patients with complex problems. 6. Identify and discuss common factors leading to patient compliance or non-compliance.

Description of course activities
 The student will spend time at Brackenridge Hospital rounding on the patients admitted to the Family Medicine inpatient service. as well as rounding on patients at the Blackstock Family Practice Clinic. The student will develop an appreciation for the interaction of medical, socioeconomic and psychological factors in the practice of family medicine and a greater understanding of the doctor-patient relationship. The student will have the opportunity to function as an intern with the Family Medicine inpatient service team. The student will undertake primary responsibility for patients assigned to his/her care and will be directly supervised by the upper level resident and faculty on the service. The student will make daily rounds with residents and faculty (including weekends). Off-days will be scheduled for the student in rotation with the residents. The student will take short call (there is no night call as there is a FLOAT resident) and will serve as the patientís primary provider. The student will also attend grand rounds, resident lectures, and other scheduled conferences within the Department of Family Medicine, as determined by the attending faculty and supervising resident.

Type of students who would benefit from the course
 This course is particularly valuable to students interested in Family Medicine or those students interested in the practice of comprehensive care in a primary care setting. To enroll, UTMB students should submit a C-form to Tricia M. McElligott and the supporting letter via e-mail to tmmcelligott@seton.org or fax at 512-324-7988 for approval. Visiting students should submit an application through VSAS and the supporting letter to Tricia McElligott tmmcelligott@seton.org or by fax to 512-324-7988: https://services.aamc.org/20/vsas/public/school/instID/174 Select UTMB at Galveston as the host institution and indicate you wish to take FAMU 4150 on the application.

Weekly Schedule
  Clinical Activities (please insert estimated schedule here)
   
  Day of Week AM PM
  Monday 7:00 - Daily Noon Conference- 5:30
  Tuesday 7:00 - Daily Noon Conference- 5:30
  Wednesday 7:00 - Daily Noon Conference- 5:30
  Thursday 7:00 - Daily Noon Conference- 5:30
  Friday 7:00 - Daily Noon Conference- 5:30
  Saturday
  Sunday
       
  Average number of patients seen per week: 7-10  
  Call Schedule:   n/a  

  Research Activities (please insert estimated schedule here)
   
  Activity Hours per Week
  Faculty contact time

  Self-directed study

  Data collection/analysis

  Other


Method of student evaluation
Check all that apply - complete appropriate section(s) only:
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
    Daily on clinical services.
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback
Other

2.  Oral Presentation
  A. Audience - To whom does the student present?
    Faculty and residents
  B. Frequency / duration of presentation(s)?
    Daily
  C. Format - What guidelines are set for the student's presentation?
    Clinical case presentations
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    Daily progress notes.
  B. Format - What guidelines are set for the student's written work?
    Clinical case format.
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
   
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
   
  F. Audience - Who assesses the studentís written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
  Format
    Oral   Written multiple choice   Written essay / short answer   OSCE
Other

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Small group activities in the hospital that consist of preparing and making presentations to attending faculty and residents. Attending resident lectures.

6.  Other Modes of Evaluation
  Please explain below.
    Students will be evaluated on their reliability and sense of responsibility for patient care. Special attention will be paid to knowledge acquired during the acting internship as well as communication and listening skills. Written consults, oral presentations, and feedback from residents on the team will also be used by the attendings to evaluate the studentsí performance.
 
7.  If this course is an Acting Internship, please complete the following:
   
  A. Specify how the student will be given formative feedback on their clinical skills.
    Students will meet with the course director and/or cheif resident at the beginning of the rotation to review the departments goals and objectives as well as the students goals and objectives of the rotation. Students will be supervised daily by residents and faculty members on the team and will be assiged to the Chief Residnet on the service. There will be ongoing feedback, as well as verbal feedback at the mid-point and at the end of the rotation.
B. List advanced clinical skills that a student will be assured an opportunity to practice.
    Students will be assigned 2 to 3 patients that they will follow. Patient history taking and physical exam skills communication with other clinical services communication with other specialties. Cognitive workup and evaluation of patients. Development of a treatment plan including what test to order and referrals to be made. Performance of some inpatient and outpatient office procedures.
C. List other advanced clinical skills that a student may be exposed to depending on clinical case availability.
    Interventional radiology procedures(paracenthesis, thoracenthesis, and endometrial biopsy. Student may observe consult services such as stress test and surgeries on their patients if the schedule allows.
  D. How will the acting intern student have responsibilities similar to a PGY1 resident? How will their responsibilities differ?
    The student will be assigned patients (2 to 3) to follow. Student will be responsible for the patient from admission to discharge.Studentis expected to see the patient everyday, write a progress note, and follow up on all test results and procedures. The student will also be involved in the discharge planning for his/her patient. Students will formulate an action plan for patients first seen by the Chief resident or attending physcian admitted from the ER or clinic if the patient is being assigned to the student. Student will be allowed to assess the patient with supervision. Differences in responsibilities to a PGY1 resident:Students will not follow the same total number of patients as a PGY1 resident, although the numbers will be similar at times. Students will be on call every 5th night instead of 4th and will have one weekend call but will not participate in overnight call. Students will not write and execute final orders on their patients.
  E. How will this course help prepare a student enter an internship in this field or a related field?
    The acting intership experience will help prepare students entering an internship in Family Medicine since it will simulate in many ways the experience of a PGY1 resident in this field. Students will have an expanded role on the medical teams, and more responsibilities than a medical student in the elective on the team.
  F. How will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?
    Midpoint feedback will be provided by the attending and/or course director. Goals and Objectives will be discussed and evaluated. Areas of deficiencies will be discussed, re-evaluated and revisited prior to the end of the rotation. May provide additional reading to the student to address weaknesses and address professionalism issues if necessary.
  G. Acting Internship students often seek letters of recommendation following their experience. How many different faculty are they likely to encounter during this course? What is the usual number of working days they can expect to encounter the same individual faculty member? Describe the degree of supervision and interaction with faculty vs. residents or other providers.
    It is anticipated that Acting Internship students will consistently work with, on average, two faculty members during a one-month rotation. During a one-month rotation, a student may expect to encounter the same faculty member for more than 7-14 days each. This may vary, though, depending on scheduling issues. Acting interns will work closely with all team members, and may expect direct & daily supervision by both residents and faculty members on the team.

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