Family Medicine

Clerkship Structure

Introduction

The clerkship is six weeks in length, beginning with one day of orientation and concluding with one study day and a final day for a written exam and evaluation. There are two types of sites available to students. One site may be a private practitioner’s office, while the other clinical experience involves working at ambulatory care centers associated with Family Medicine residency training programs. These experiences offer similar but not identical experiences. Please remember, the preceptors are volunteer teachers; always remain courteous and respectful of both patients and office staff.

Orientation

Loyola Orientation. During the first one day of the clerkship, a general orientation is scheduled at the Loyola campus. Most orientation sessions begin on a Monday, unless there is a legal holiday. All students are expected to attend the entire orientation. The Clerkship Director must approve any absence.

At the Loyola orientation, the clerkship syllabus will be reviewed. The orientation will also include didactic sessions and interactive activities that should assist you in your rotation and required projects. Topics covered during the orientation might include:

Adolescent Health

Asthma Management

Community/Underserved Medicine

Diabetes Management

Domestic Violence

History of Family Medicine

Musculoskeletal Medicine

Obesity Management

Sexual Dysfunction

Sports Medicine

Women’s Health

On-site Orientation. Each clerkship site has an assigned faculty member responsible for your educational experience. When you arrive at your clinical site you will meet with your preceptor/supervising attending. Plan to review your “Important Dates to Remember” page (see binder side pocket) with your assigned preceptor. We expect students to spend at least 30 hours per week in direct ambulatory care, with the remaining time used for reading and completing assignments and projects, rounding on inpatients, attending educational programs, etc. Residency-based programs usually offer a more formal orientation to the site. You should discuss with your preceptor how your time will be allotted at this first meeting. You should think about what your personal goals are for the clerkship.

If it is not immediately clear who your assigned preceptor is please notify the Site Director or Clerkship Director as soon as possible. We expect each student to have a preceptor who is ultimately responsible for his/her experience. If you are in a “private office” you should meet with this person virtually every weekday. The only exception will be if your preceptor is on vacation or is off one day per week. In this case, your preceptor may assign another attending to meet with you on those days. At residency practices, you will work with a number of residents and attendings. However, you should meet with your supervising attending at least twice per week.

Educational Programs On-site. The residency program faculty may plan educational programs unique to its site. Examples may include lectures or visits to a health department program or nursing home. Attendance is mandatory if required by the supervising faculty. Each preceptor may also offer unique experiences of which we encourage students to take advantage such as attending hospital staff or department meetings or attending continuing medical education programs. The preceptor should also assist you in identifying patients who are suitable for your projects. If you find it difficult to select appropriate patients or topics for your projects, inform the Education Coordinator.

Attendance . See the student manual “Introduction To Clinical Years,” for the SSOM policy on clerkship attendance. Should the Loyola policy differ from that of your assigned site, please inform the Education Coordinator. In most cases, the Loyola policy takes precedence over the clerkship site policy. The Clerkship Director must approve any known absences, in advance. Written documentation, such as a copy of a wedding invitation, airline tickets or a program, must be provided. If you have an unforeseen emergency, call both your site and the Loyola Education Coordinator to inform them you will not be in clinic. Extreme situations will be dealt with on an individual basis. Make-up may be required.

Too Tired To Drive Home Policy. If, for any reason, you are too tired to safely drive home you can obtain a taxi ride to your home. At Loyola or Hines, Loyola.wired web page (http://portal.luhs.org) and login to the INFORMATION PORTAL. At the bottom of the page, click on the Way To Go! Taxi Voucher link for American Taxi Service. When at other sites, call a taxi, pay, and bring the receipt to Amy Andel (SSOM, Room 320) for reimbursement. A ride back to the hospital is also underwritten.

Eighty-hour work week. Your total time at a clinical site cannot exceed 80 hours/week. This includes "call" not more than every fourth night and a minimum of one full day off/week. For violations, notify the Site and Clerkship Director.

Blood Borne Pathogen Exposure. With any needle stick or similar exposure, immediately wash the affected area. Report the incident to your immediate supervisor. Go to the site's Occupational Health Service or, after hours, to the site's ER. The important issue is to receive antiviral prophylaxis for potential exposure to HIV infected material within 1-2 hours of the exposure. You must also notify Loyola's Occupational Health Service (708-531-7900) or, after hours, page the on-call OHS staff member (708-216-8777 pager 19480).

Non-Sexual/Sexual Harassment/Mistreatment. Stritch has a policy of zero tolerance for such treatment. For instances of non-sexual mistreatment, you are encouraged to find support with a variety of resources, including the Clerkship Director, Campus Ministry/Pastoral Care, personal counseling services, our Medical Center Employee Assistance Program (EAP) counselors, any of the deans or trusted faculty. If you believe that the issue needs more formal investigation/resolution, you should contact the Associate Dean for Student Affairs. In instances of Sexual Harassment, Stritch is governed by our Medical Center's Sexual Harassment Policy and all allegations of sexual harassment must be formally investigated. You may seek confidential consultation through the EAP or Office of Campus Ministry to explore options for addressing the concern, and you are strongly encouraged to notify the Associate Dean for Student Affairs.

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Weekly Checklist

The following checklists are to assist you in progressing smoothly through your rotation and to make sure you complete all of the assignments on time.

Week One

Review initial responsibilities.
Review competencies.
Familiarize yourself with the staff and their responsibilities.
Find out about your office space, parking, and meals. Get ID badges and other administrative responsibilities accomplished, depending on site.
Review general office policies, including charting, dictation, and the appointment system.
Start working on the Med-U fmCASES: http://med-u.org, the Radiology Curriculum & Working w/ Families article.
Read the syllabus and be familiar with all required assignments, and discuss with your preceptor.
At the end of the week, discuss with the preceptor how things are going and discuss your goals.
Complete and sign your educational contract, and discuss with your preceptor.
Fill out the log card and any critical incidents at the end of each day.
Enter patient data into the portal.

Week Two

If you are not seeing patients on your own, request that you begin to do so.
Identify a suitable patient for the biopsychosocial assignment and arrange for an interview to carry out the assignment.
Begin to complete your Procedural Checklist.
Continue MedU fmCASES: http://med-u.org , the Radiology Curriculum & Working w/ Families Article.
Review your initial personal goals and performance to date with the primary preceptor.
Identify a clinical question for the Evidence-Based Medicine (EBM) assignment, clear it with your preceptor and contact a Research and Access Services Librarian (216-5305) to schedule a meeting. You must have your search strategy reviewed by a librarian and get their signature before turning in your final project.
Enter patient data into the portal.

Week Three

Make sure you are seeing at least 3-5 patients per half-day session on your own and writing SOAP notes for them.
Make sure you are about halfway through your Procedural Checklist by the end of the week.
Ask preceptor to discuss, complete and sign your mid-rotation evaluation. Print out Student Log Report and have signed.
If not already completed, interview your patient for the Biopsychosocial Project. Complete the written portion of the assignment and prepare for oral presentation to the group at SSOM.
Present your Biopsychosocial Project at Loyola and be prepared to discuss how things are going with the faculty facilitator.
Enter patient data into the portal.

Week Four

Continue Med-U fmCASES: http://med-u.org , the Radiology Curriculum & Working w/ Families Article.
Continue to work on the EBM assignment.
Enter patient data into the portal.

Week Five

Continue completing your Procedural Checklist.
Continue MedU fmCASES: http://med-u.org , the Radiology Curriculum & Working w/ Families Article.
Review your log card. If obvious gaps in certain types of patient problems are seen, discuss with preceptor and try to rectify.
Make sure you are seeing at least 6-8 patients per half-day session on your own and writing SOAP notes for them.
Enter patient data into the portal.

Week Six

Complete all required fmCASES: http://med-u.org, the Radiology Curriculum & Working w/ Families Article.
Complete EBM assignment and turn it in at your final exam.
Elicit feedback from your preceptor on your clinical evaluation. Print out Final Student Log Report and have signed.
Prepare for final exam.
Enter patient data into the portal.

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Practical Tips for Enhancing Your Clerkship Experience

Initial Responsibilities

As with all positive learning experiences, a key factor influencing your success is the ability to communicate effectively. To achieve the most from the clerkship experience, establish your presence with the preceptor and become involved in the clinical environment as quickly as possible. When you become involved, those with whom you interact will also become involved. The following tips will assist you in getting the most from your clerkship experience:

Introduce yourself to the people with whom you’ll be working.
Be pleasantly assertive -remember you are a new member of the team.
Share your goals and interests with your preceptors and others who may assist in your learning.
Determine the equipment you will need to interact in this environment--stethoscope, watch, identification card, note pad, resource book, etc.
Dress --Present yourself as a professional and representative of Loyola University Stritch School of Medicine throughout your clinical experience. You will be expected to wear your white jacket at all times when seeing patients. Wear your nametag and any additional name tags required by some hospitals.
Problems --Approach your preceptor if you perceive there is a problem. Contact the Education Coordinator if there are irreconcilable differences.
Report Abuse – Immediately contact the Education Coordinator if you are being subjected to any form of abuse.
Absence --Make sure you notify the preceptor if you must be absent (not the secretary or receptionist). Preceptors are aware of the absence policy for the clerkship. Let the site coordinator know how to contact you in case of emergency, and always contact the Education Coordinator at cmerric@lumc or 708-216-1356.