The central goal of the Family Medicine clerkship is to help you to enhance your skills in applying the Patient-Centred Clinical Method to understand the patient's personal experience of their illness and find common ground regarding management decisions.
This includes:
Students are assigned to communities throughout the province for part of their clerkship. To ensure that minimum competencies and objectives are encountered, the Family Medicine Tracking Form was created as an adjunct to the tracking book that the overall clerkship requires of students. Though completion of all elements on the tracking form is not a requirement to pass the rotation, deficiencies noted on the form will be discussed at the exit interview for purposes of developing remedial opportunities.
1. Medical Expert/Decision Maker
a) Present a pertinent history and conduct a relevant physical exam, under supervision, on an adult or elderly patients presenting with the following complaints:
i. new or chronic cough
ii. fatigue
iii. low back pain
iv. fever
v. shortness of breath
vi. abdominal or pelvic pain
vii. headache
viii. dizziness
ix. chest pain
x. lower leg swelling
b) Present a relevant and focused differential diagnosis to your supervisor, on an adult or elderly patient presenting with the following complaints:
i. new or chronic cough
ii. fatigue
iii. low back pain
iv. fever
v. shortness of breath
vi. abdominal or pelvic pain
vii. headache
viii. dizziness
ix. chest pain
x. lower leg swelling
c) Describe (to your supervisor and/or the patient) an approach to the management of the following presenting complaints in an elderly or adult patient:
i. new or chronic cough
ii. fatigue
iii. low back pain
iv. fever
v. shortness of breath
vi. abdominal or pelvic pain
vii. headache
viii. dizziness
ix. chest pain
x. lower leg swelling
d) The student will conduct (under supervision) a relevant history and physical exam for an adult or elderly patient with established diabetes presenting to the out-patient family medicine clinic for a diabetic check-up.
e) The student will manage (under supervision) an adult or elderly patient with established diabetes presenting to the out-patient family medicine clinic for a diabetic check-up. The student should also list the pertinent screening procedures done for a patient with diabetes.
f) The student will manage (under supervision) an adult or elderly patient presenting to the out-patient family medicine clinic with either established hypertension or established dyslipidemia. The management should include a discussion with the patient and/or supervisor of the appropriate medications, their common side effects and alternative treatments.
g) The student will participate in the care of an elderly patient, either in a long-term care facility, the acute care setting (i.e., the emergency department) or the out-patient family medicine clinic under the direction of their supervisor.
h) The student will demonstrate a prenatal exam (under supervision) on a female adult patient (as measured by completion of appropriate procedures and examination as directed by the antenatal flow sheets).
i) Given an infant, child or adult presenting to the out-patient family medicine clinic, the student will administer an intramuscular or subcutaneous immunization under supervision.
j) Given an infant presenting to the out-patient family medicine clinic, the student will demonstrate a well-baby exam under supervision.
k) Given an adult female patient presenting to the family medicine out-patient clinic, the student will perform a pap smear where appropriate.
2. Communicator/Educator/Humanist/Healer
a) Given an adult between the ages of 50-70 presenting to the out-patient family medicine clinic, the student will demonstrate a periodic health exam under supervision and will list to the supervisor relevant screening procedures appropriate for the patient in question.
b) Conduct patient-centered interviews that explore the patient's feelings, ideas, impact on function, and expectations.
c) Develop relationships with patients characterized by compassion, empathy, respect, and genuineness, demonstrating a willingness to collaborate with the patient about management.
d) Perform a physical examination without causing the patient embarrassment.
e) Adapt treatment plans to the individual with consideration for the patient's age, general health, special needs, expectations, cultural background, progress, or changes in condition.
f) Demonstrate skill in communication of information with clear, concise explanations that are understandable to patients.
g) Recognize risk factors and be able to counsel patients on risk reduction.
3. Health Advocate
a) Identify the rights and legal responsibilities of physicians to patients and the community.
b) Describe the determinants of health and apply them appropriately to enhance individual and community well being.
c) Apply the concept of cost-effectiveness to public health interventions.
4. Learner/Scholar
a) Demonstrate skill in self-directed learning by:
i. Ability to identify areas of deficiency in one's own knowledge and skills.
ii. Ability to find appropriate educational resources.
iii. Ability to evaluate personal learning progress.
iv. Ability to use new knowledge in the care of patients.
b) Determine the validity and applicability of published data through critical appraisal.
5. Professional/Collaborator/Person
a) Given a patient of any age presenting to the out-patient family medicine clinic or acute care setting (i.e., the emergency department), the student will demonstrate skill in finding common ground when differences of opinion exist.
b) Demonstrate the ability to work effectively as a member of a team, as participant or leader.
c) Collaborate effectively with patients and families without having to take charge.
d) Demonstrate skill in finding common ground when differences of opinion exist.
e) Establish effective relationships with colleagues and other member of the health care team by:
i. Considering their suggestions and criticisms.
ii. Tactful handling of differences of opinion.
f) Demonstrates the ability to place the needs of patients and families first.
g) Demonstrates honesty and trustworthiness in assessment, study and learning.
h) Demonstrates responsibility and respect.
i) Recognize personal biases and ensure that they do not interfere with the patient's best interests.
j) Be willing to seek help, advice or consultation when needed.
k) Respond to personal and family needs and develop effective support systems
6. Resource Manager/Gatekeeper/Steward
a) Use the concepts of evidence-based medicine to guide patient care decisions.
b) Assist patients in accessing the health care system for physical, psychological, social, and economic rehabilitation or long-term care.
c) Identify potential conflict between individual and population interests and seek advice from others.
7. Scientist
a) Assess the effectiveness of practice and engage in continuous quality improvemen