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Electives - Family Medicine

ACE - A. I. in Family Medicine

Elective Number: 1401

Rotation Supervisors: Dr. Mark Cohee

Designated Signer: Wanda Hudson, McKim 3161 (wmh9v@virginia.edu )

Duration: Maximum: 4 weeks, Minimum: 4 weeks

Available: Rotations 1-6 (ACE LOTTERY); rotations 7-12 contact Wanda Hudson

A pager is required and will be provided by the department.

Report to: Family Medicine Inpatient Attending (contact Wanda Hudson)

Time to Report: 8:00 am

Place to Report: Family Practice Center, Primary Care Building, Conference Room C

Typical day: 6:00 am - 6:30pm - hours vary with the inpatient census - these times are approximations.

Attendance: A student may not take time off during an ACE.

Attendance at elective activities is mandatory.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of students per rotation:

Course Description: To provide medical students with a supervised, one-month experience that closely resembles the activities and responsibilities of a family medicine intern. Emphasis will be placed on obtaining a family medicine inpatient experience with the opportunity to obtain supplemental experience in an academic family medicine outpatient clinic. Students must attend morning reports and grand rounds.

Learning Objectives: Students completing the elective will be expected to:
1. Become equal members of the family medicine inpatient team and demonstrate competency in providing the following essential components of inpatient care for Family Medicine patients:

• Admission assessment; initial history; initial physical examination; initial working diagnosis and differential diagnosis
• Development of a treatment plan
• Writing orders for medications, activity, and diet
• Ordering appropriate tests; interpreting lab tests
• Writing daily progress notes, transfer and admission notes
• Discharge planning
• Calling consults in to sub-specialty services
• Updating patients’ family members (under direct supervision) on the treatment plans for their patients

2. Demonstrate the ability to conduct a well-organized presentation of their own patients to the inpatient team while on rounds. These presentations are to include adequate discussion of the patient's history, physical findings, diagnosis, assessment (including the daily assessment), and treatment plan (including the need for further diagnostic or treatment plan) as well as a commentary on the patient’s anticipated discharge plan.

3. Be able to effectively present patients during radiology rounds and other potential forums for patient discussion outside of formal rounding with the team.

4. Incorporate the use of evidence-based clinical calculators (Coumadin dosing, admission criteria for pneumonia, etc.) into treatment plans whenever appropriate

5. Take evening and weekend call according to policy (see attached) and assist family medicine resident with admissions

6. Demonstrate the ability to communicate effectively with and work collaboratively with inpatient team members, other treatment services, support staff and para-clinical staff (nurses, PT, respiratory therapy, specialty consults, emergency room, nutrition and social workers)

7. Participate actively in teaching and learning activities;

8. Participate in a minimum of one labor and delivery (if possible based on patient volume).

9. Describe and if possible perform the basic technique for performing the following procedures: Blood draw, lumbar puncture, arterial blood gas, thoracentesis, paracentesis and nasogastric tube placement.

10. Demonstrate the ability to interpret the following lab tests as they relate to the care of the patient: acid base/electrolytes; EKG; ABG; chest x-ray; abdominal films; comprehensive chemistry panel; urinalysis; PT/INR; CBC.

11. Demonstrate the ability to work-up an initial treatment plan the following common hospital issues: pneumonia, chest pain, hypoxia, sepsis, altered mental statues, asthma exacerbation, COPD exacerbation and diabetic ketoacidosis.

12. Learn about basic principles of Information Mastery

13. Under the supervision of a faculty member or senior resident, develop a clinical question, perform a related targeted literature search, and present the findings to the clinical team (10 minute presentation)

14. Read independently about patient problems seen in the hospital setting.

15. Practice and become proficient at advanced physical exam skills.

16. Achieve a ‘competent, average, above competent, or highly competent’ rating from the supervising faculty for history taking, physical exam, development of management plans, and written notes.

17. Achieve an ‘average competence for 4th year student’ or above rating from the supervising faculty for incorporating psychosocial issues into care of patients; or, for lower scores develop a strategy to practice and improve this skill during the 4rth year.

18. Demonstrate the qualities of commitment, trustworthiness, integrity, compassion and respect of the patient's autonomy, confidentiality and need for information.

19. Model professional attributes with regard to professional responsibility