Electives - Family Medicine
Caring for Refugees in Charlottesville: International
Family Medicine Clinic
Elective Number: 1416 (arranged)
Rotation Supervisors: Dr. Fern Hauck
Coordinator: Wanda Hudson, McKim 3161
Evaluation should be given to: Dr. Hauck or Ms. Hudson
Duration: 4 weeks ONLY
Available: Rotations 1-3, 5-12 & 14 (not offered
in R4 or R13)
Report to: Dr. Hauck
Time to Report: To be arranged in the week prior to start date
Place to Report: To be arranged in the week prior to start date
Typical day: 8:00 am - 5:00 pm
Attendance: 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
Number of students per rotation: 1
Course Description: This elective is designed to prepare the student
to care competently and sensatively for international patients. The focus will
be on developing clinical skills to care for patients who present for initial
and follow-up visits to the IFMC, including screening for common infections
and illnesses, preventive care, management of acute problems and management
of common chronic conditions. Above all, the student will learn how to communicate
effectively with international patients, both in working with interpreters
and learning to be culturally appropriate and sensative. The student will also
learn about legal issues and distinctions between "immigrant" and "refugee"
and the various community health, social and educational agencies that serve
these populations locally. This elective will prepare students to work with
international patients both at home and abroad.
Students will see patients during 4-5 half-day sessions each week in the IFMC,
working with the IFMC providers. Students will also spend one session a month
at the Health Department Refugee Clinic (where initial screening for infectious
diseases occurs), the International Rescue Committee (resettlement agency),
and UVA Traveler's Clinic, based on availability.
remainder of the time will be spent reading the required readings and preparing
the final project. This project will focus on one cultural
group and include an in-depth description of the group's home country, customs,
health practices and common illnesses, and immigration history and circumstances
leading to immigration. Other topics will be considered on a case-by-case basis.
Students will be evaluated on clinical performance.
The following objectives are from the SOM core competencies in cultural competence
and apply to this elective. Students completing the elective will be able to:
- Key Concepts in Cultural Competence
- Address the importance of social determinants (e.g., education,
status, housing and employment) and community factors on health.
patients'/families' healing traditions/practices and beliefs, including
beliefs (this includes the "historical models of common health beliefs" such
as illness in
the context of "hot and cold").
- Ask questions in a
non-jUdgmental manner to elicit patient preferences, listen and
respond appropriately to patient feedback about key cross-cultural
- Discuss race, ethnicity, and culture in the context
of the medical interview and health
care. Exhibit comfort when conversing with patients/ colleagues
and describe institutional
cultural issues for own institution.
- Value the importance of
curiosity, empathy, and respect in patient care and the
importance of continuous growth as a healer.
- Bias, Stereotyping, Culture and Clinical Decision Making
and identify own potential for bias and stereotyping; explore how attitudes,
biases and stereotypes affect clinical encounters, clinical decision
making and quality of
- Identify and appreciate how physiCian bias and stereotyping
can affect interactions with
patients, families, communities, and other members of the
health-care team, and the link
between effective communication and quality care.
- Cultural Competence
in Patient Care
- Conduct and document a culturally responsive
history and physical examination; elicit a
cultural, social and medical history, including a patient's
health beliefs or model of their
illness using Kleinman's Explanatory Model questions.
respect for the patient's cultural and health beliefs and use negotiating
problem-solving skills in shared decision-making with
- Discuss CLAS Standards (Culturally
and Linguistically Appropriate Services) and how
they are being implemented in the hospital, health
system, or clinic in serving patients
with limited English proficiency.
- Describe the functions of
an interpreter (both in-person and via telephone) and effective
ways of working with an interpreter.
- Identify when an interpreter
is needed and collaborate effectively with an interpreter.
and enhance patient adherence based on the patient's explanatory model.
- Describe ways to enhance patient adherence by collaborating with traditional/community
Additional learning objectives also specific to
- Develop clinical skills to care for refugee
patients who present for initial
and follow up visits
to the IFMC including:
• Identify and screening for common infections and illnesses.
• Recognize appropriate preventive care screening and counseling.
• Manage of acute medical problems.
• Devise appropriate treatment plan for common chronic medical conditions
effectively with international patients, including using
- Describe the unique legal issues related to refugees
- Compare and contrast
the distinction between "refugees" and "immigrants" and
affects access to health to
the community agencies that work with and/or assist
Department and International
a project including submission of a written report
under the supervision
rotation supervisor or
her designee that assesses
point or issue
the care of refugee patients
in the ambulatory setting.