Patient Presentations Commonly Seen in the Clerkship

During the Family Medicine Clerkship you will see patients in an ambulatory continuity-of-care setting.   Your patients will usually present with common conditions.  Some are being seen for the first time, while others have been coming to the clinic for years.  Your patients will often have needs and concerns that are different from those you have experienced in other settings of your medical training.

You will diagnose and initially manage a wide range of primary care conditions during the clerkship.   For many years, the clerkship faculty compiled and analyzed data from the students’ Patient Log Forms to identify the conditions with which patients commonly present in an ambulatory primary-care setting.  The most common medical problems that clerks encountered during the Family Medicine Clerkship are:

The NBME Family Medicine Specialty Exam, which you will complete on the last Friday of the clerkship, assesses your ability to diagnose and initially manage conditions like those listed above.   Reading about the conditions you see in specific patients, the clerkship’s formal learning activities, and studying the recommended text, will help prepare you for the examination.

Clerkship Learning Activities

The Family Medicine Clerkship consists of carefully planned learning experiences that will contribute to your primary care education and enhance your knowledge about the many roles of family physicians.   Each carefully planned experience exists for a particular purpose.  Those experiences and their purposes are explained below.

• Patients: Learning from patients is probably the most valuable and exciting part of the third year.  Thus, caring for patients will be a key part of your clerkship experience.  Taking histories and performing physical examinations will hone your basic medical skills.  Seeing patients in an out-patient setting will expose you to a wide range of patient problems and the related issues that often accompany acute and chronic illnesses.
  
  

• Procedures: Family physicians perform a variety of in-patient and out-patient procedures. Observing and performing procedures such as minor excisions, circumcisions, and sigmoidoscopy will extend your knowledge base, polish your patient communication skills, and provide you with opportunities to use your skills.

• Didactics: Experienced family physicians at your clerkship site will share their knowledge and experience in scheduled sessions that use lecture, conference, and case-based teaching formats.  Participants in the common clerkship didactics hosted at UT Southwestern will also interact in weekly sessions; providing brief reports on a variety of preventive and clinical medicine topics.  Didactic topics cover common entities seen in family medicine and likely subject areas for the required NBME exam.       

• Patient Presentations: You must develop the ability to present to attendings and residents.  Presenting patients to these individuals will polish your organizational and presentation skills and increase your confidence.  You will also make a formal patient presentation.  (See Appendix D for details.)

• Self-Study: Expanding your fund of knowledge is your individual responsibility.  Reading about your patients, researching didactic topics, and studying for the NBME Family Medicine Specialty Examination will help develop your knowledge base.

• Site-Based Activities: Each Family Medicine Clerkship site is unique, but shares much in common with the other sites.  Participating in site-based activities such as home visits and nursing home visits will broaden your perspective about family medicine and expose you to patients whom you would otherwise not see in your third year.

• Clinical Passport:   The Clinical Passport identifies specific diagnostic skills that must be successfully learned and demonstrated by each student and observed and documented by a faculty member.  The passport also documents your involvement with visit types and diagnoses that we consider the core curricular experiences in family medicine. The goals of this program are to improve the clinical skills of our students, to encourage clinical teaching and feedback, and to enhance the exposure of our students to faculty on the clinical clerkships.  A completed and signed passport is a course requirement.  It must be turned in when you take the final exam.

Clerkship Site Director

Each clerkship location has a faculty member who is designated as site director.   This individual is responsible for the day-to-day management of your clerkship experience.

             You are responsible to your local clerkship site director for all scheduling and other assigned duties.

Absence Policies

Planned Absences:   All planned absences/tardy arrivals must be approved by the clerkship site director on the first day of the rotation, or earlier when possible.  The course directors at UT Southwestern must be notified also, by email.

Unplanned Absences:   Any unplanned absence/tardiness (i.e. for an illness) must be reported to:

             1) the clerkship site director as soon as possible by telephone AND

             2) the course directors at UT Southwestern by email.

Professional Conduct and Attitudes

All students must demonstrate an acceptable standard of professionalism during the family medicine clerkship.  All activities on the clerkship schedule are required.  All assignments must be completed by the designated time.

You will interact with patients and their family members, attending physicians, residents, other health care providers, office staff, and fellow students during the clerkship.   Therefore, you must dress and behave in a professional manner in all clerkship activities.  You are expected to wear your white coat and name badge.  Men should wear a dress shirt and tie when seeing patients.  Women should dress in a similar professional manner.  Scrubs should not be worn while seeing patients in the clinics at any of your sites, regardless of how you see residents dressed. You should identify yourself as a medical student or student doctor when greeting patients.  Show respect to patients and health care providers by addressing them by their proper title: Mr., Mrs., Ms., or their professional designation.  Take advantage of every learning opportunity and show appreciation for the time and effort others contribute to your training.

Respect others at all times.  Appreciate the cultural, ethnic, and familial differences all patients possess.  Show patients respect by only discussing them in private with the appropriate health care provider.  The clerkship provides experience with physicians in office, clinic, hospital, and other settings. Observing and learning from these faculty in clinical and classroom settings will enhance your development as a physician - regardless of the specialty you pursue as a career.