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Family and Community Medicine

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The Family and Community Medicine Clerkship is designed to give each student a continuous daily clinical experience lasting four weeks, in an ambulatory primary care office. The criteria for determining the types of patients and clinical conditions are inherent in the design of the clerkship.

Thus each student is placed in the office of an approved primary care preceptor and is expected to participate in the care of any patient who presents with a problem. Students are assigned to various primary care sites in New York City, Westchester county as well as sites in rural Ulster county. The clinical experience is structured to afford students the opportunity to accomplish the goals and objectives of the clerkship. The level of student responsibility is progressively increased over the first few days of the clerkship, depending on the amount of previous clinical experience the student has had.

Student responsibility incorporates a combination of observation of the preceptor, performing histories and physical examinations with the preceptor present, and independently performing complete or focused histories and physical exams and presenting the findings to the preceptor. Discussion with the preceptor includes establishing the differential diagnosis and clinical management of the presenting problems. At times the student and preceptor may examine the patient together, and the student will then discuss the diagnosis and plan with the patient. Students are expected to participate in the care of at least four patients per half-day teaching session, keeping track of each encounter in the student log. They are expected to work with the preceptor at least 30 hours per week.

Practical Nursing issuesStudents are given a list of the most common problems encountered in primary care, and they are expected to learn about the presentation and management of these problems through observation, patient contact, discussions with the preceptor and required readings including a required text. They are also encouraged to attend conferences and rounds with their preceptors if available.

In addition, each student is expected to select a patient from the site and to do an in-depth history and physical exam and psychosocial history. The patient is then written up by the student for the required Index Case. The preceptor aids in the selection of a patient who has one or several common primary care problems and who is willing to talk with the student at length. These cases are presented to small groups on the final day of the Clerkship.


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