Family Medicine Residency Program/Cheyenne

University of Wyoming

Clinical Clerkship Course Description

University of Wyoming Family Medicine Residency Program at Cheyenne

General Objectives of the Student

1) To introduce the student into the Family Medicine arena with its flavor, diversity and its

1. i) All-inclusiveness, its involvement in all processes and events of life and death
   ii) Variety that brings the opportunity to learn more than is offered in most other medical specialties
   iii) Ability to supply warmly gratifying emotional returns that come from those with whom we share life's problems

2) To determine one's own compatibility with this medical specialty.
3) To provide information and experience that will supplement skills acquired in other fields.
4) To meet medical school requirements for work in a primary care specialty.
5) To introduce environmental and geographical variety into the medical school process and experience.
6) To make use of an opportunity to augment one's ability to deal with oneself and other human beings.
7) To improve the special knowledge and technical skills required in Family Medicine.

General Objectives of the Program

1) To offer the facility, leadership, supervision and patients with which the student's objectives may be met.
2) To provide a measure of the student's level of attainment in various areas of family medicine so that strengths and weaknesses may be recognized by the student.
3) To provide guidance and, as far as is possible, the clinical opportunity to satisfy specifically perceived needs.
4) To provide an evaluation of the student's progress, especially in those areas of increased emphasis or to correct deficiencies.

Specific Objectives

1) To practice and thus improve the student's skills in:

1. i) Interviewing and obtaining pertinent and complete patient histories
   ii) Performing complete and/or specific physical examinations
   iii) Formulating an assessment and plan and presenting it in a concise yet complete manner.

2) To organize historical and physical findings into a sharply defined data base.
3) To do all this competently enough to assume some responsibility for patient management.

4) To begin to acquire more specific skills pertinent to Family Medicine, such as:

colonoscopy	immobilization techniques
local anesthesia techniques	joint aspiration
minor surgical techniques	lumbar spinal tap
joint injections	urinary bladder catheterization
endoscopy	incision and drainage
pelvic examinations and evaluations

5) To be exposed to behavioral science as it applies to the practice of family medicine to:

1. i) Gain further understanding of the psychological and social aspects of family medicine
   ii) Further develop a style of physician-patient interaction which is caring, enhances patient self-disclosure, and promotes patient care
   iii) Further develop appropriate strategies for handling the "difficult patient"

Evaluation

On-going evaluation will be concerned with attitudinal characteristics in the student such as professionalism, communication, the ability to receive and incorporate feedback and the ability to work as part of a multidisciplinary team. The student should be seeing patients more comfortably and quickly at the end of the rotation than at its beginning. Chart records should reflect a student's increased capacity to gather pertinent historical material, to perform a physical evaluation and to combine these data into a coherent assessment and plan.

The student will be developing knowledge, skills and abilities in various areas, making determinations of strength and weakness, and setting a course accordingly. No final oral or written examinations are scheduled unless required (and administered by) the student’s medical school.  An evaluation will be completed by the faculty physician responsible for medical student rotations.  This is typically supplied by the medical school.

Number of Students

The number of students that can be accepted varies according to time of year, contractual obligations to train students from specific schools and faculty availability for supervision and education.  These clerkships are limited to fourth year students from accredited allopathic or osteopathic schools. International medical graduates are selected on an individual basis.

Transportation

A public transportation system is not available in Cheyenne. Therefore, we require that you be responsible for providing your own means of transportation during your clerkship.

Board/Room

The University of Wyoming Family Medicine Residency Program at Cheyenne is able to provide a dislocation allowance for a one-month clerkship. Shorter rotations will be prorated accordingly.

Malpractice Insurance

Professional liability insurance is the responsibility of the student or the medical school. The completed clerkship application, which includes that statement, should be in the program files prior to the beginning of the clerkship period. The University of Wyoming Family Medicine Residency Program does not provide professional liability coverage for medical students.

Orientation

A brief orientation is scheduled during the first day of each clinical clerk's experience here. This includes a tour of the facility, introductions to staff, discussion of charting and the EMR, the basic "rules" of the rotation, and a verbal contract of expectations mutually agreeable between the student and program. A separate orientation will be provided by the hospital regarding their EMR. The student will be assigned to a team and given a desk from which to work. An individualized schedule will be given to the clerk for the month's experience.

Clerkship Activities and Priorities

The rotation will be divided between the hospital (Cheyenne Regional Medical Center) and the Family Medicine Center.  Hospital exposure for the clerk will be as a member of the In-Patient Family Medicine team.  The clerk will spend time in the Family Medicine Center working with a resident physician or faculty member.  Approximately half of the rotation will be spent in each setting. 

Selection of Patients for Student Care

The clerk will be seeing patients with a resident physician or faculty member and they must present the patient to the faculty member or clinic attending in the clinic prior to the patient's checkout.

Supervision

All patients seen by the student must be discussed and seen with the attending faculty or resident physician before the patient leaves the Center. The name of the faculty consulted should be noted in the electronic medical record. Patients seen in the hospital will be discussed with the senior resident or the team before morning report. Notes and orders will need to be co-signed.

Laboratory and X Ray

The clerk is expected to become familiar with the routine in which studies ordered are done. Positive findings are to be personally examined; procedures to be understood and performed as deemed appropriate by the student or preceptor. X rays and EKGs are to be read or examined and interpretations independently made by the student and reviewed with the preceptor. The resulting impression should be compared to the final reading by the radiologist in the case of x-rays and the attending physician in the case of EKG's.

Problem Oriented Medical Records

The POMR and SOAP formats are used in the Family Medicine Center and hospital. Students should become familiar with these methods of documentation and are expected to use it consistently.

Prescriptions/Pharmacy

The student may be asked to write prescriptions. Typically, prescriptions are sent electronically by the resident or attending.  If a paper prescription is written, the attending faculty or a licensed resident must sign all prescriptions. Discussions with the clinical pharmacist are encouraged when questions regarding drugs and their actions/interactions arise. Small quantities of drug samples are available for patient use in the Center, but all prescriptions must be filled elsewhere.

Lecture Series

Conferences are scheduled on a regular basis. Attendance is required in most cases. There are certain conferences that the student is excused from.

Summary

The faculty, residents and staff of the University of Wyoming Family Medicine Residency Program at Cheyenne are dedicated to doing our best for those who come to us for care. Equal dedication is given to the learning process by which this is done. All of us share an interest in these objectives and recognize that medical students serving their clinical clerkships are an important and integral part of the program. The privilege of caring for human beings in all facets of their lives and helping them to feel better is rewarding and enjoyable. We anticipate the opportunity to share this unique experience with students of medicine.

 

 

Revised 3/11/2019