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 Introduction |
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| The Department of Family Medicine manages and participates in a wide variety of Medical Education activities. In addition to our residency programs and fellowship opportunities, our faculty members have developed, currently direct, or serve as instructors in a wide variety of courses for medical students. |
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| Requried Courses |
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Medical Interviewing
The Introduction to Medical Interviewing Course teaches first-year students the interpersonal skills necessary to elicit and explore a patient’s medical history. Sixteen pairs of faculty teach small groups of students with the help of actors who portray patients with a variety of complaints. The course, which has existed in some form since 1978, is consistently highly rated by students and by faculty who return year after year to teach.
Several of our faculty also participated in the advanced medical interviewing class.
Third-Year Family Medicine Clerkship
The Family Medicine Clerkship is a four-week-long required experience in Family Medicine for third-year medical students. Guided by an innovative “Virtual Family Medicine Classroom,” students receive directed and didactic education in the wide range of clinical issues in Family Medicine, with a strong emphasis on preventive medicine services, culturally competent health care delivery, and the integrative biopsychosocial model of clinical practice. Students rotate in a variety of settings, seeking the common thread of the process of care delivery in the specialty of Family Medicine. These include outpatient offices, the hospital, the labor and delivery suite, the nursing home, assisted living, care in the patient’s home, and care in the community setting. Students are required to write a paper addressing significant health issues from a medical, social, and cultural perspective, based on a home visit with a patient they see in continuity over the four weeks. Students are provided feedback and mentorship by a full-time faculty member as well as direct feedback by clinical faculty, fellows, and residents serving as preceptors in distressed inner city, urban, suburban, small town, and rural locations. New rigorous grading standards and minimum requirements were established during this academic year. Robert W. Smith, M.D., MBA served as the Clerkship Director.
Advanced Physical Examination
Students are guided through the various steps of the physical examination in order to improve their clinical skills in the time prior to their assignment to clinical duties in the third and fourth years.
Clinical Skills
Departmental faculty participate in the teaching of a clinical skills course—an opportunity to focus on physical examination skills over several weeks and testing of students on objective proficiency. Several of our faculty also participated in the “bridge” course, facilitated by Donald Middleton, M.D. of our Department.
Family Medicine Acting Internships
The Department offers a wide variety of acting internships for fourth-year medical students. These opportunities are primarily located at each of the three residency training sites (UPMC St. Margaret; UPMC Presbyterian/Shadyside, Shadyside Campus; and UPMC McKeesport). In addition, through special arrangement with a number of affiliated Family Medicine residency programs in the Department’s residency consortium, students are offered the opportunity to serve as acting interns in other institutions in Western Pennsylvania, including UPMC Horizon, Washington Hospital, and Latrobe Regional Hospital.
During the acting internships, the student is expected to function with relative independence in decision making, developing not only clinical skills, but methods of approaching problem solving and the exercise of a level of leadership, critical for future professional development.
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| Electives |
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ELECTIVES
Electives are offered in a wide variety of fields, providing students the opportunity to focus on challenging populations in need of improved health care delivery. The courses are often arranged in a manner designed to stimulate the student to develop critical thinking skills, associated with the leadership characteristics that will be required for future function in the health care system, no matter what specialty they choose.
Indian Health Service
Electives in Family Medicine and Community Health are available on American Indian reservations and in Native Alaskan areas. The Indian Health Service (IHS) provides a variety of programs for fourth-year medical students at IHS hospitals and clinics throughout the United States. Students live in government quarters and work under the supervision of United States Public Health Service physicians. Most sites offer a heavy emphasis on outpatient medicine, while providing some inpatient experience as well. Indian Health Service programs emphasize community health activities and often provide students with opportunities to make home visits with public health nurses, participate in preventive medicine programs, and/or work in remote field clinics. In general, students will need to arrange these rotations on their own. Rotations are popular and are often filled ten months in advance at some sites. Students are given considerable opportunity to manage patient care. At some sites (Tuba City, AZ and Rapid City, SD), there is also an opportunity for students to participate in epidemiological and public health projects under the supervision of IHS physicians.
Clinical Epidemiology
Students may do a faculty-guided tutorial in 1) the general principles of clinical epidemiology or 2) the application of clinical epidemiology principles to the understanding of health or disease. Students may participate in one of the ongoing epidemiology biostatistical projects including an overview of all phases of the project or a specific, targeted research phase. Students may design an independent clinical epidemiology research study employed to answer a specific research question. The area could be a variety of clinical or public health issues.
Community Family Medicine
This elective is intended to offer medical students the opportunity to experience Family Medicine in a remote community setting which is realistic to how family physicians practice. The student will focus on developing skills necessary to evaluate and treat patients in a community office setting. The degree of responsibility will be determined by the knowledge and skills of the student. The student will be exposed to the community family physician’s patient responsibilities, call schedule, community activities, family, and lifestyle. The project will address the needs of the community of practice.
Family Practice Elective Away
This elective is offered to an unlimited number of students over all 12 periods. Emphasis is on the development of ambulatory care skills, the treatment of medical and psychosocial problems common to the community, and preventative medicine. The elective will allow students to hone their patient interviewing and physical exam skills, as well as providing longitudinal and personal care for individuals. Students are responsible for arranging their rotation with a board certified preceptor either in private practice or in a residency program at any away site. They must generate and submit a set of written goals for their rotation to both their intended preceptor and to the course director, Dr. Richard Zimmerman, for approval.
International Medicine
This elective is intended to give some structure and guidelines for students wishing to experience medical care in another country. In this elective, students may focus primarily on experiencing the practice of medicine in other countries, or they may focus additionally on epidemiologic and public health issues within the country. Dr. William Markle and Dr. N. Randall Kolb provide third- and fourth-year students with an international experience through the Pittsburgh Shoulder to Shoulder Foundation. Students spend a two-week period in Honduras under direct faculty guidance learning the challenges of care in a distressed nation among the poor, exploring barriers to care including cultural attitudes, poverty, inadequate delivery systems, public health issues, and lack of advanced technology for diagnosis and treatment.
Practice-Based Pharmacotherapy
The student will participate in a variety of activities (direct patient care, group/individual case-based discussions, chart reviews, and projects) to improve skills in prescribing and management of medications. The UPMC St. Margaret Family Health Centers are located in underserved areas of Pittsburgh. The population they serve faces significant barriers to optimal pharmacotherapy. Special emphasis will be placed on obtaining a thorough medication history and using evidence-based drug information databases. Students will use this information in combination with the routine history and physical to optimize therapy for a variety of conditions and circumstances including diabetes, hypertension, infectious diseases, antithrombotic therapy, dyslipidemia, asthma, and chronic obstructive pulmonary disease (COPD). The student will learn rational prescribing strategies based on cost, formulary guidelines (lists of medications approved for use per health systems and insurance companies), effectiveness, and individual patient characteristics. Students will work with clinical pharmacists and family physicians with a special interest in rational prescribing.
Integrative Medicine
The Integrative Medicine Elective is offered to one senior medical student and one resident each month. The rotation has been revised to provide more time with integrative medicine preceptors in the community. To recap, this is a full-time elective in which the students and residents spend time with a number of integrative and complementary medicine practitioners observing their approaches. There is also a didactic component and each trainee is responsible for a presentation on an integrative medicine topic of interest.
Community-Based Public Health Policy
During this one-month experience, each student will learn the basic principles of identifying health problems from a population perspective and developing policies to help solve problems. Students will work closely with faculty in the Department of Behavioral and Community Health Sciences of the Graduate School of Public Health. Activities include required reading, working on existing projects with community-based organizations, using health databases to answer questions about the health of communities, and preparing a written and oral report based on each student’s own assessment of a community, one particular problem in that community, and a rational approach to developing health policies to address it.
Primary Care Sports Medicine
In this course, the student will participate in a wide variety of activities in order to improve his/her musculoskeletal diagnostic and exam skills and to promote understanding of the field of primary care sports medicine. Experiences include direct patient care with primary care sports medicine faculty and fellows, group didactics, training rooms, group/individual case-based discussions, time with physical therapy and hand/occupational therapy, and musculoskeletal radiology sessions. Game coverage is dependent on the season, but is encouraged. Based on interest, we also strive to include exposure to neuropsychiatric and concussion/impact testing and exercise physiology.
Medical Student Research Training and Longitudinal Research Program
The School of Medicine curriculum requirement that was implemented with the first-year students in the 2006 academic year states that each medical student must complete a scholarly project. In addition to this requirement, additional opportunities exist for more extensive training including the Enrichment Program in Biomedical Research and the Longitudinal Research Program. Dr. Jeannette South-Paulserves as the Director of Medical Student Community-Based Research with oversight of the Medical Student Longitudinal Research Program, the community-based scholarly projects, and the enrichment program in biomedical research.
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