ROTATION GOALS & OBJECTIVES
The Department of Family Medicine offers a month-long rotation in ambulatory care. Where the physician has the opportunity to see a wide variety of common problems in this setting. This rotation focuses on ambulatory care of Family Medicine patients and is designed to increase the first year resident's comfort with patient care in the ambulatory setting.
EDUCATIONAL GOALS & OBJECTIVES
a. Exposure to common ambulatory problems
b. Treatment of both acute and chronic problems
c. Emphasis on preventive medicine
d. Documentation and accurate coding
e. Improvement in oral presentations and clinical skills
Value of Information/Experience to the Transitional Year Intern:
A number of the patients who are seen in the Family Health Center are adults and elderly patients. Opportunities to see these patients and to experience the operation of a private practice should provide preparation for future practice.
Principal Teaching Methods:
The physician will learn by seeing and evaluating patients. Then the physician will present these patients to the faculty who serve as precepting physicians. There is discussion regarding the findings and the differential diagnosis in order to arrive at an appropriate treatment plan.
Educational Content of the Rotation:
The patients seen will consist of all ages from newborn to the elderly. This will also include obstetrical patients. Some opportunities for outpatient procedures may be available.
Components of the Physical Exam Stressed:
The Transitional Year Interns will be required to do a complete physical exam.
Opportunities include giving immunizations; vision, hearing and pulmonary screening; EKG interpretation; minor office surgery; stress testing and ultrasound for obstetrical patients; and endoscopy.
Goals and Objectives of the Family Medicine Rotation
At the end of the Family Medicine rotation the Transitional Year Interns will develop knowledge of:
Medical Knowledge: Competency
- Normal anatomy and physiology of the adult
- Principles of complete history taking and physical examination of the adult patient
- Principles of preventive health including risk reduction and screening
- Gastrointestinal disorders including hepatitis, cirrhosis, pancreatitis, colitis, diverticulitis, cholecystitis, peptic ulcer disease, and bowel obstruction
- Endocrine conditions including diabetes mellitus, thyroid disorders, adrenal diseases, and lipid disorders
- Renal conditions including urinary tract infections, nephrolithiasis, acute and chronic renal failure /obstruction
- Musculoskeletal conditions including back pain, rheumatoid arthritis, collagen vascular diseases and osteoarthritis
- Infectious diseases (bacterial, viral and fungal) that are commonly encountered in the adult population
- Neurological conditions including stroke/TIA’s, seizures, meningitis, coma, movement disorders, dementia, nerve entrapment syndromes and tumors
- Pulmonary disorders including asthma, COPD, bronchitis, pneumonia, thromboembolism, fibrosis, neoplasms, respiratory failure and evaluation of pulmonary function testing
Patient Care, Practice-Based Learning and Improvement, and Systems-Based Practice:
- Perform a comprehensive history and physical examination of the adolescent and adult patient
- Develop a rational plan of care for his patient, including identification and reduction of risk factors with consideration of the social and economic impact of treatment on the patient
- Understand current concepts in medical record documentation
- Interpret an EKG
- Interpret pulmonary function tests
- Prepare and interpret a gram stain
- Aspirate and inject a joint
- Perform cardiopulmonary resuscitation
- Perform a flexible sigmoidoscopy
- Perform a thorocentesis
- Perform a paracentesis
- Perform a lumbar puncture
- Patient Care and systems
- Assess post hospitalization needs and initiate appropriate services
- Participate in patient education and family conferences regarding hospitalization of a family member
Most opportunities for performing the above procedures come during the course of caring for assigned inpatients; some (EKG interpretation, flexible sigmoidoscopy) are specifically taught in the MAHEC Family Health Center.