1. To promote a patient-centered model of care:
A) Through understanding of the PATIENT/PHYSICIAN RELATIONSHIP students will master the concept of patient-centered care.
Students will:
- Discuss and analyze the patient, family, and physician factors which contribute to the patient/family/physician relationship.
- Learn to define boundaries in the patient-physician relationship.
- Demonstrate the fundamentals of the doctor-patient relationship in the clinical setting.
B) Through understanding of the PATIENT FACTORS affecting care,
Students will:
- Define factors that affect patients' satisfaction with their medical care and compliance to the management plan. - Discuss examples of how lifestyle, work habits, stress, gender, race, religion affect the presentation and evolution of various illnesses and maintenance of health - Become sensitive to the different coping styles by which a patient responds to illness.
C) Through understanding of the PHYSICIAN FACTORS affecting care,
Students will:
- Demonstrate competencies in history taking, physical examination and management skills that focus on the patient in the context of a particular illness in a variety of clinical settings.
- Develop appropriate interpersonal skills in the patient/physician relationship. Be aware of common ethical issue confronting a family physician in his daily practice.
- Recognize physician factors that would affect the patient/physician relationship.
2. To develop an ambulatory care approach:
Students will demonstrate the ability to:
1. Take a history
2. Carry out an appropriate physical examination
3. Manage frequently encountered acute problems presenting to a family physician, such as: Hypertension, diabetes, thyroid problems, COPD., pregnancy, anemia, low back pain, peri- drug overdose, obesity, URI, chest pain, articular problems, headache, UTI, depression, confusion in the elderly, loss of autonomy, rashes, screening issues, functional disorders, constipation, diarrhea, family and marital problems, terminal illnesses, sexual problems, STD's, the abused child, pneumonia, otitis media, work-related illness.
4. Manage frequently encountered chronic problems presenting to a family physician, such as: Diabetes, asthma, COPD, CHF, arthritis, depression, anxiety and certain cancer patients.
5. Manage undifferentiated problems presenting to a family physician
6. Elaborate an appropriate management plan, including the appropriate use of diagnostic tests
7. Acquire skills in appropriate consultation and patient transfer
8. Demonstrate skills in such procedures as:
- Pelvic examination
- Pap test, cervical cultures and chlamydia test
- Breast examination§ Testicular examination
- Rectal examination
- Venipuncture
- SC, IM, ID injections
- Examination of an infant
- Vital signs (BP, T, oral and rectal, P)
- Basic laboratory techniques (wet mounts, obtaining urine cultures,
- U/A, throat swabs, pregnancy tests, rapid strep test, etc).
3. To perceive the patient as part of a family and the community:
Students will:
- Discuss how relationships with others affect the patient in health and in illness.
- Relate the impact that an illness may have on a family and a family on an illness.
- Describe and appreciate how the economic, social, and cultural context of the community may influence the patient both in health and illness.
- Demonstrate an understanding of how to involve the family in a patient's care.
- Know what community resources are available and how to use them.
4. To promote continuous and comprehensive care:
Students will:
- Understand the importance of the initial encounter with a patient and the need to establish a contract for care.
- Practice ongoing and comprehensive care to individuals and families in health and in illness.
- Demonstrate an understanding of the family physician's role as health care coordinator.
- Demonstrate an understanding of the role of the attending physician and the consultative process.
5. To foster health promotion and disease prevention:
Students will:
- Understand and apply the principles of periodic health examination:
- Risk identification in specific populations
- Strategies to diminish risks and promote health maintenance - Develop skills in counselling in such areas as: well child care, contraception, safer sex, injury prevention, tobacco use, obesity, substance abuse, family violence, and other family problems.
- Understand the role of the public health department.
- Be able to recognize problems in their patients that pose a risk to the public health (such as infectious, occupational, or environmental disease) and manage them properly.
- Be able to understand the distribution and determinants of health problems in their community.
6. To teach the need for continued self-directed learning:
Students will:
- Set goals for the clerkship in coordination with the supervisor, review them at the end of the second week, and evaluate them at the end of the rotation.
- Consult the relevant literature and describe its application to the diagnosis and management of patients for whom they are responsible.
7. To provide an opportunity for an informed career choice:
Students will:
- Gain first-hand experience in primary care medicine and be better able to consider Family Medicine as a career choice.
- Compare and contrast various career options within family medicine and various practice settings.
- Discuss, with their supervisor and in small group settings, specific career goals.