Primary Care 1

Student goals for this clerkship:

It is expected that you will meet, evaluate and follow children, families, and adults with a range of acute and chronic problems that require care. Certainly, many of these patients will have serious medical illnesses that merit intensive diagnostic testing, pharmacologic treatment, and referral. Some of these patients will express difficulties in coping with illness, and adapting to situations in the home or complaints such as fatigue or palpitations, financial problems, or seek advice from their physician about specific foods, medications, or activities. These patients will need you to listen to their problems with empathy and understanding. They will value your time taken to better inform them about their regimen, or to refer them to experts in social service, counseling, or nutrition. Some patients will be women seeking gynecologic care and family planning consultation. Others will be seen with pediatric, medical or surgical subspecialists for more advanced diagnosis and management. Since many of these patients will be seen over time, you will enjoy the opportunity to learn more about the various ways that illnesses manifest, resolve, and advance during that period.

You can anticipate that this experience will challenge you to master your clinical skills in medical interviewing, physical diagnosis, laboratory assessment, including skills in the interpretation of tests, reviewing X-rays and reading EKGs. Your knowledge of basic pathophysiology, differential diagnosis, and the management of diseases will grow, as will your ability to set reasonable priorities for each medical encounter. This priority setting will necessarily involve consideration of the patient's perspectives and needs.

In addition, you will develop new skills and knowledge in areas such as preventive medicine, patient education and counseling, occupational and rehabilitative medicine, clinical nutrition, and emergency care. Learn how to do a diagnostic evaluation and work-up in an ambulatory setting including laboratory test and clinical and radiographic procedures. Learn how to make and implement a therapeutic plan in an ambulatory setting and to enhance compliance. Learn the principles of prescriptive screening and secondary prevention in an ambulatory setting. Gain familiarity and experience with the acutely ill patient in the ambulatory setting. Learn to research and present a topic/conference on Primary Care subject. Learn and increase familiarity and comfort in outpatient Gyn evaluations. Develop Primary Care values of bio-psychosocial approach to patient care and to include, emphasis on prevention, continuity, comprehensiveness and emphasis on function rather than strict disease orientation. Some students will be exposed to home care for older patients, and learn aspects of clinical geriatrics that will be new to them. Others will focus more on the needs of adolescent patients and their families. Some will see primary substance abusing patients, who may be more open to rehabilitative efforts.