Family Medicine Rural Clerkship

Family Medicine is a six-week clerkship in which students are assigned to a family medicine practice throughout the state of South Carolina. Students gain core clinical skills and knowledge in primary care with an emphasis on the importance of ambulatory care and the patient-physician relationship.

Family Medicine Rural Clerkship Objectives
At the end of this rotation, the student will be able to do the following:

Medical Knowledge (MK)

1. Describe the known pathophysiology, epidemiology, risk factors, and the course of commonly encountered conditions in family medicine (see PxDx log and Aquifer Family Medicine cases objectives). (MK3, MK4)
2. Describe the scientific principles underlying diagnostic methods, including laboratory and radiologic testing, and treatment approaches (pharmacologic and non-pharmacologic) that may be applied to major diseases and conditions. (MK5)
3. Explain how preventive measures, health behaviors and social determinants affect disease, injury and health in individual patients and across populations. (MK7)
4. Demonstrate knowledge of the critical evaluation of current basic and clinical sciences in application to diagnosis and management of common patient conditions (MK8)

Patient Care (PC)

1. Demonstrate proper techniques for interviewing a patient to obtain pertinent medical history and performing diagnostic and directed physical examinations in the office setting. (PC1)
2. Formulate differential diagnoses based on patient history and physical exams in office settings. (PC2)
3. Interpret results from commonly used laboratory tests. (PC3)
4. Evaluate patient problems in a community and family context. (PC3)
5. Identify how interpersonal relationships, social characteristics and cultural norms can alter the presentation and management of an illness. (PC3)
6. Refer patients to other health professions and agencies as appropriate. (PC4)
7. Counsel, educate, and partner with patients, families, and the community to promote health and prevent health problems using accurate, current evidence-based information (PC5)
8. Organize and prioritize responsibilities to provide care that is safe, effective and efficient. (PC6)
9. Perform diagnostic and screening procedures utilized by primary care physicians in comprehensive patient care. (PC7)
10. Develop and implement an evaluation and management plan. (PC3)

Interpersonal and Communication Skills (CS)

1. Communicate effectively with patients, families and colleagues using active listening and appropriate verbal, nonverbal and written skills. (CS1)
2. Foster therapeutic and ethically sound relationships with patients across a broad range of socioeconomic and cultural backgrounds with respect, empathy and support of emotions. (CS2)
3. Evaluate the nature of the physician-patient relationship and its impact upon the management of the patient’s illness. (CS2)
4. Assess the patient and the family in the context of the bio-psychosocial model. (CS2)
5. Create clear, accurate and organized progress notes. (CS5)

Professionalism (PR)

1. Demonstrate honesty, integrity, respect, and compassion in all interactions with patients, peers, faculty, staff, and other health care professionals in all settings. (PR1)
2. Demonstrate ethical, patient-centered decision-making and respect for the confidentiality of patient information in all settings (i.e., clinical, academic, electronic or web-based). (PR2)
3. Demonstrate sensitivity and responsiveness to the personhood of the patient inclusive of culture, race, ethnicity, spirituality, gender, sexual orientation, age, physical characteristics, medical condition, disabilities, socioeconomic status, family-context and other aspects of personal and health beliefs, practices and decisions. (PR3)
4. Demonstrate accountability for academic and patient care responsibilities, and a commitment to continuous professional development. (PR4)

Personal and Professional Development (PD)

1. Acknowledge personal limitations and mistakes openly and honestly, and critically evaluate mistakes to promote professional development. (PD1)
2. Demonstrate strategies for analyzing, identifying and improving personal deficiencies in knowledge and skills by setting learning and improvement goals. (PD2)
3. Demonstrate a commitment to personal health and well-being, and recognize and address personal attributes, attitudes, and behaviors that may adversely influence one’s effectiveness as a physician. (PD3)

Practice-Based Learning (PL)

1. Identify and apply principles and tools of continuous quality improvement to enhance patient care. (PL4)
2. Apply principles of population health improvement to the system of care within a medical practice with attention to access, cost and patient-centered clinical outcomes. (PL6)

Systems-Based Learning (SL)

1. Advocate for quality, cost effective patient care and describe strategies for coordinating care within complex system. (SL2)
2. Describe health disparities and health care disparities; how they affect patient and system outcomes, and identify ways to effectively address disparities.(SL4)

Interprofessional Collaboration (IP)

1. Define the roles and responsibilities of various health professionals in the healthcare team. (IP1)
2. Work with health professionals to establish and maintain a climate of mutual respect, dignity, diversity, ethical integrity and trust. (IP2)
3. Collaborate with other health professionals including Pharmacy, Social Work, Public Health and Nursing in providing care of individual patients, families of patients, or groups of patients who share similar health concerns. (IP4)
4. While working with other health professionals, maintain a climate of mutual respect, dignity, diversity, ethical integrity, and trust. (IP2)
5. Communicate effectively and respectfully with other health professionals in a responsive and responsible manner. (IP3)
6. Work with various health care professionals including nurses, physician assistants, nurse practitioners, social workers, genetics counselors, ultrasound technicians, and financial counselors to improve individual patient care and system performance. (IP4)

Family Medicine Rural Clerkship PxDx Log

Diagnosis: Participate in the care of patients with the following diagnoses:	Output or Input
Anxiety	O,I
Chest Pain	O,I
Chronic Respiratory Disease (asthma, COPD, ILD, etc.)	O,I
Congestive heart failure	O,I
Depression	O,I
Diabetes mellitus Type 2	O,I
Dizziness	O,I
Fatigue	O,I
Genitourinary complaints (vaginitis, UTI, ED, BPH, etc.)	O,I
Headache	O,I
Hypertension	O,I
Insomnia or other sleep disorder	O,I
Knee Pain	O,I
Low Back Pain	O,I
Obesity	O,I
Preventive care	O,I
Shoulder pain	O,I
Skin rash	O,I
Substance use disorder	O,I
Upper Respiratory infection (OM, OE, sinusitis, pharyngitis, etc.)	O,I
Wounds	O,I
Uncontrolled diabetes	O,I
Procedure	Output or Input
Participate in the management of outpatient chronic, non-cancer pain	O,I
Perform an interpretation of an EKG	O,I
Perform Nutritional counseling	O,I
Perform Smoking Cessation Counseling	O
Perform an AUDIT (alcohol use disorders identification test)	O,I
Participate in an interprofessional experience (Working with nurse, PharmD, phlebotomy, radiology technicians etc, participating in an AHEC IP case)	O,I
Exam	Output or Input
Perform a pertinent exam for a patient who presents with an acute or chronic musculoskeletal complaint	O
Perform a cardiopulmonary exam on a patient	O
Perform a HEENT exam on a patient	O