Family Medicine

Family Medicine Sub-Internships and Electives

Boston University students interested in any of the following Family Medicine elective or subinternship offerings should contact Ms. Florence Laforest.

Telephone: 414-6237
Location: BMC-Dowling 5 Room 5414

SUB-INTERNSHIPS IN FAMILY MEDICINE

030.1i Title: Sub-internship in Family Medicine
Instructor: Chris Manasseh, M.D.

Location: Boston University, New Inpatient Facility (Menino Pavilion)
Number of Students Per Block: One
Period to be offered: Blocks 9 – 19

Description of Elective: Students will work as a member of team B4 on the medicine service at the Menino Pavilion, BMC. The patient pool will be from the HealthNet Rounder system at BMC.
Students will be acting interns working with 2nd and 3rd year Family Medicine residents. They will be responsible for evaluation and management of patients on the B4 team. Residents and the family physician ward attending will provide daily supervision, support, teaching, and feedback with respect to sub-intern’s patients including the history obtained, physical exam findings, and management plans.
There are many formal teaching opportunities available. Subinterns will attend and participate in the following scheduled educational activities:
•Daily medicine morning report at 7:30 am in the conference rooms across from the cafeteria, 2nd floor at the Menino Pavilion.
•Monday: Family medicine resident noon conference – Peabody conference room, Dowling 1st floor.
•Tuesday: Family medicine noon conference – Dowling Amphitheater, 1st floor
•Wednesday: Medicine firm conference at 11:30 am, 6th floor conference room, Menino Pavilion.
•Wednesday : Family medicine afternoon seminar, 1 p.m. to 4 p.m., Dowling 5 south
•Thursday : Primary care noon conference
Students will also meet regularly with the B4 Ward attending for teaching rounds, case review and bedside work rounds. Weekly sub-intern teaching rounds with Firm B chief/designate is also offered.

This Subinternship is offered to Boston University students as a priority. After BU students select this subinternship, non-BU students may enroll space permitting.

Note: This elective satisfies the subinternship requirement

ELECTIVES IN FAMILY MEDICINE

031.1 Title: Narrative Medicine Elective

Instructors: Joanne E. Wilkinson, MD, Department of Family Medicine
Location: Online and Dowling 5 South (Department of Family Medicine) for two in-person meetings.
Telephone: 617-414-6198
Number of Students: Flexible. Available to both BUSM III and BUSM IV students
Period to be Offered: Three times a year: Fall semester (14 weeks from Sept to Dec); Spring semester (14 weeks from Jan to May); and Summer (12 weeks from May to August).

Please note: This elective has been designed to be completed as an overlay to the regular four week electives, i.e. to be taken simultaneously with the regular, fourth year four week electives during the time periods shown. The elective will not appear on the transcript and no grade will be assigned, but a letter of completion will be sent to each student’s file.

Description of Elective: This elective is designed to introduce students to the concept and framework of narrative medicine. It consists of readings, online discussion of the readings, narrative writing assignments and a few in-person meetings. The goals of the course are 1) students will learn more about the concept of narrative medicine and how it applies to their understanding of their patients’ stories; and 2) students will produce and receive feedback on their own writing, allowing them to process and understand the personal aspects of some of their clinical experiences to date. Every two weeks, there will be reading assignments and two writing assignments to be posted on the course discussion board. One of the assignments will be a personal essay; the other will be designed to generate discussion of some of the themes in the reading. There will also be midterm and final papers, both personal narrative assignments for the student to further explore their voice as a writer.

 

032.1 Maternal/Child Health
Instructor: Jennifer Pfau, M.D.
Location: Boston Medical Center
Number of Students Per Block: Selective Blocks, Please Inquire
Period to be offered: Blocks 9 – 19

Description of Elective: This elective gives students a true family medicine-centered experience to include prenatal/perinatal care (including labor and delivery), inpatient postpartum care for women, as well as newborn nursery care for their infants. The student will spend mornings on the postpartum floor caring for women and their infants- you will focus on issues such as breastfeeding (including spending time with our lactation consultants), the newborn exam, routine postpartum care, maternal counseling and anticipatory guidance.  Afternoons will be spent either seeing primary care patients in clinic (including as many prenatal/pediatric visits as possible), or researching a maternal/child health topic of your choice to be presented at the end of the elective.  Students take call overnight on labor and delivery one night per week, allowing them an opportunity to be actively involved in deliveries and all aspects of labor and delivery care.  Each student chooses one weekend to work with the postpartum/nursery rounder to get more direct clinical experience.  Participation in this elective provides you with a wonderful opportunity to be an active and important team member with a lot of independence.  Students who will derive the most benefit from this rotation are self-motivated and active learners.

 

030.1c Title: Elective in Family Medicine – Central Maine Medical Center
Instructor: Raj Woolever, M.D.
Location: Central Maine Medical Center Family Medicine Residency, 76 High Street, Lewiston, ME 04240
Number of Students Per Block: One
Period to be offered: Blocks 9-19
Housing: Available
Food: Cafeteria pass for unlimited food is provided

Description of Elective: Students will learn about the specialty of Family Medicine and what makes Family Physicians unique in the way they care for patients and families. The clerkship is primarily an outpatient experience (includes 1 week of Family Practice Inpatient Service) in which the student works in a busy community hospital family medicine center which serves as the continuity site for the residents and faculty. There is also an opportunity to spend some time in a rural family practice office if requested by the student. Clinical clerks will see outpatients independently and generate a history, appropriate physical exam, assessment and plan before presenting the patient to the family practice preceptor. This combination of caring for rural families plus an inner-city under-served population at the Residency provides rich learning opportunities encompassing a variety of medical, psychiatric and social concerns. Students will also have exposure to Family Medicine inpatient care, attend deliveries, participate in outpatient procedures and home visits. Students will take call with a senior resident and residency faculty attending over the course of their preceptorship. Students will participate in a comprehensive didactic curriculum presented at the noon hour and meet weekly for a case conference with the program director or one of the faculty.

This elective is offered to Boston University students only.

 

030.1d Title: Family Medicine Subinternship
Instructor: Beth Kurtz, MD
Location: Fitchburg Family Practice, 275 Nichols Rd, 4th floor, Fitchburg, MA 01420, 978-878-8381
Number of Students Per Block: One
Period to be offered: Please Inquire
Housing: Available

Description: The goal of this elective is to offer the student the opportunity for primary patient responsibility as a member of a team of family practice residents and attending family physicians on an inpatient family medicine service. The service includes pediatric, obstetric, ICU and medical patients. Students take histories, perform physicals, write orders and progress notes, and participate in rounds. Supervision is provided by senior family practice residents and the Chief Resident. Students spend one half-day per week at the FP Health Center to provide follow-up care for recently discharged patients and gain clinical experience managing ambulatory patients in the family practice setting. The SubInternship takes place in a nearby community hospital (Leominster Hospital) in an unopposed Family Practice Residency environment.

This subinternship is offered to Boston University students only.
Note: This elective satisfies the subinternship requirement for BUSM students.

030.1e Title: Advanced Outpatient Family Medicine-Community Health Center
Instructor: Suki Tepperberg, M.D.
Location: Family Medicine Center, Boston Medical Center, Boston, MA 02118
Number of Students Per Block: 1 in Block 13, 2 in Blocks 14 and 15
Period to be offered: Blocks 13, 14 and 15
Housing is not available.

Description of Elective: Students who are entering the field of family medicine are the target for this elective.  Students will see ambulatory patients at one or two of the affiliated residency sites, including South Boston Community Health Center, East Boston Neighborhood Health Center and Codman Square Health Center. With appropriate supervision students will be expected to have first contact with patients and to do the initial work-up. The student will work with a variety of Family Medicine residents and preceptors. Students will gain skills in the diagnosis of the undifferentiated patient, and the assessment and management of acute and chronic problems which commonly present in family medicine. Instruction in patient education and preventive medicine in the family context will be emphasized. Students will participate in staff conferences and may attend rounds, conferences and lectures that are part of the BMC Family Medicine Residency Program.

This elective is also available through the Boston Medical Center Minority Recruitment Program.

033.0 Title: Elective in Advanced Healthcare Communication

Instructor: Suzanne Mitchell, MD MS

Location: BUMC/Hancock Manor Nursing Home
Number of Students Per Block: 6
Period to be offered: Blocks 17, 18 and 20
Housing: Not available

Description of Elective: During this four-week elective, students will cultivate a deeper understanding of the complex interactions between patients, healthcare providers and healthcare systems and the relationship to health outcomes. Topics to be explored include:

  • · Cross cultural communications and the influence of clinical uncertainty, stereotyping and unconscious bias in physician decision-making and the propagation of health disparities.
  • · Communicating with “difficult patients”.
  • · Building skills in Patient Activation
  • · Healthcare communications, Health Literacy and Patient Safety
  • · Physician self-disclosure in the clinical setting
  • · Efficient relationship-centered care

Learning Objectives:

1) Gain awareness of issue of health and healthcare disparities,

2) Appreciate effects of unconscious bias, clinical uncertainty and stereotyping on patient care decisions.

3) Learn and practice new skills in cross cultural communication

4) Learn and practice key competencies in healthcare communication, including effective provider-patient dialog for information gathering and trust and relationship building, eliciting the explanatory model, expression of compassion and empathy, and negotiation of care plans.

5) Acquire skills in managing difficult and sensitive clinical scenarios such as addressing lifestyle behaviors (ie, substance abuse, high-risk sexual behaviors, smoking cessation, domestic violence), eliciting advanced directives, navigating a “difficult” patient encounter.

Learning Experiences:

1) Students enrolled in the elective will meet with the course director once per week for a 2-3 hour workshop session addressing a topic in advanced healthcare communications. A discussion on an assigned reading or film clip will facilitate discussion on key topics. Other workshop activities include role play, reflective writing, use and discussion of the Implicit Association Test.

2) At the beginning of the elective, each student will be paired with a patient to follow for the month. The student will follow the patient from the inpatient setting to discharge including making a home visit and accompanying the patient to follow up outpatient visits with specialists, PCP or other allied health visits. The student’s responsibility is to learn and report back on the patient’s experience in transitions of care and correlate how healthcare communications is hindering or facilitating the patient’s quality of care experience.

3) Clinical care: Student will be assigned to participate in either an ambulatory care clinic or inpatient ward team one to two times per week for interviewing opportunities only. (Ongoing patient care will be the responsibility of the ward team.)

Learning Tools:

1) Video with Debriefing: World’s Apart

2) Clinical care experience with preceptor

3) Reading, Tuesdays with Morrie, Kitchen Table Wisdom

4) Student-Patient Pairing Experience

5) Role plays/Clinical precepting for practice in eliciting advanced directives, assessing health literacy, motivational interviewing, difficult conversations or managing difficult patient scenarios.

6) Relevant articles from the medical literature

7) Small group discussions for issues of health disparities, clinical uncertainty in decision-making and implicit bias in patient care.

 

Suzanne E. Mitchell M.D. is a board certified family physician, medical educator and consultant in physician-patient communication.  In addition to her research activities in healthcare disparities, Dr. Mitchell provides training for medical professionals in cross cultural communication, patient-centered care and patient activation.  She has served as course director for the Healer’s Art course at Tufts University. Dr. Mitchell received her doctorate degree from Wake Forest University School of Medicine and completed post-graduate training in Family Medicine at White Memorial Medical Center Family Medicine Residency Program.  Dr. Mitchell holds a Masters of Science in Clinical Research from the University of California, Los Angeles. Her research interests are in health disparities in transitions of care, healthcare and cross cultural communications and healthcare access. Dr. Mitchell is an academic faculty fellow in the Boston University School of Medicine Department of Family Medicine.

 

034.0 Title: Primary Care Sports Medicine

Course Director: Florence LaForest (Florence.Laforest@bmc.org)

Office phone:  617-414-6237

Course Instructor: Alysia L. Green, MD

NUMBER OF STUDENTS: One 4th year BU medical student

PERIOD: Block 12, 13,14, 17, and 18

LOCATIONS: Boston Medical Center, BU Ryan Center for Sports Medicine, BU Student Health services, BU Athletic Training Room, Emerson College Athletic Training Room and various athletic fields/venues for event coverage

 

OBJECTIVE: To gain exposure and experience in the field of primary care sports medicine

 

GOALS

-         To improve history taking and physical examination skills

-         Development of a solid musculoskeletal examination

-         Development of a focused differential diagnosis based on history of injury and physical examination findings

-         Determining what further testing modalities are needed based on the differential diagnosis

-         Exposure to athletic training and rehabilitation of the injured athlete

-         Understanding the role of the team physician, student athlete and athletic trainer

-         Gaining game coverage experience

 

FACULTY

Alysia L. Green, M.D-Family Medicine/Primary Care Sports Medicine

Matthew Pecci, M.D-Family Medicine/Primary Care Sports Medicine

Douglas Comeau, D.O-Family Medicine/Primary Care Sports Medicine

Arturo Aguilar, MD-Family Medicine/Primary Care Sports Medicine

 

ADDITIONAL FACULTY

Mark Laursen, Director of Athletic Training Services, Boston University

Brian Vesci. Senior Athletic Trainer, Boston University

Amanda Nicoles, Head Athletic Trainer, Emerson College

 

CURRICULUM

The curriculum will include multiple experiences in primary care sports medicine. A sample of a weekly schedule of clinic time and other experiences would be the following:

-5 half days of Primary Care Sports Medicine

-2 half days in BMC orthopedics with Drs. Comeau and Green in our orthopedic clinics

-Wednesday afternoon Sports Medicine Conference

-1/2 day BU Athletic Training Room working one on one with BU Athletic Trainers and covering different athletic practices.

-1/2 day Emerson College Athletic Training Room with Dr. Green

-1/2 day of reading time

-Game coverage: will vary depending on the time of year and block but anticipate at least 1-2 game coverage opportunities per week of the elective. Please note much of the game coverage occurs in the evening and/or the weekends so student needs to be aware they may have to work late and possibly on the weekends.

 

EVALUATION

The student will have a mid-block evaluation of their achievement of the above stated goals, done by Alysia L Green M.D. with the written/verbal input of the other physicians and additional staff members. At the end of the rotation, the student will be responsible for presenting a 30 minute presentation based on a sports medicine case that they observed during the rotation or a sports medicine topic of their interest. They will further be evaluated throughout their rotation on their musculoskeletal examination skills.