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   email: flafores@bu.edu
Location: BMC-Dowling 5 Room 5414

SUB-INTERNSHIPS IN FAMILY MEDICINE

030.1i Title: Sub-internship in Family Medicine
Instructor: Chris Manasseh, M.D.    Team: East Newton Family Medicine Inpatient Service

Location: East Newton Pavilion, Boston University Medical Center
Number of Students Per Block: Two
Period to be offered: Blocks 9 – 20

Overview

Students will work as interns with the family medicine inpatient team. They will care for a wide variety of patients from the HealthNet Rounder system, acting as the primary care-giver for their patients. They will have all the responsibilities of an intern, including daily management of their patients, new admissions, attending conferences and participating in daily teaching.

Description

  • Location: E6W, team meets in the FM conference room 6269 by the nurse manager’s office
  • Daily schedule: Generally 7am to 6pm 6 days per week, one day per week will be extended until 7pm to allow for independent admission. Team sign-out 7am, teaching 7:30-8, bedside rounds 8:30, daily noon conferences, pm sign-out at 6pm
  • Students are expected to work 3 weekend days during the month, arranged in discussion with the senior resident. NOTE: students follow the holiday/vacation schedule of the team not of Boston University, speak with the team prior to making any travel arrangements
  • Students will be directly supervised by the 2nd or 3rd year resident in addition to the family medicine ward attending.
  • Students will be primarily responsible for the care of their patients, they will participate in all conferences, daily teaching

 

Curriculum

  • Daily bedside and teaching rounds, new admissions, morning teaching sessions
  • Presentations for 2 morning teaching sessions
  • Focused H&P review with course instructor
  • Conferences:
    • Monday – Family medicine resident noon conference, Dowling 5th floor south wing, dept. of family medicine;
    • Tuesday: Family medicine grand rounds, FGH conference room;
    • Wednesday : Family medicine afternoon seminar, twice per month, 1 p.m. to 4 p.m., Dowling 5 south;
    • Thursday : HealthNet firm conference, ENP 2nd floor, 12 NOON, lunch provided

 Objectives

  • Assess, formulate a differential diagnosis, and propose initial evaluation and management for patients with common acute ambulatory presentations (U,R)
  • Manage a chronic illness follow up visit for patients with common chronic diseases
    (U, C, R, S)
  • Develop an evidence-based health maintenance plan for a patient of any age or either gender (U, R)
  • Discuss the principles of family medicine care (B, U, C, E, S)
  • Demonstrate competency in advanced history-taking, communication, physical examination, and critical thinking skills (B, C, A)
  • Discuss the value of the provision of primary care by family physicians to any health care system (U, S)

 

Evaluation:

  • Evaluation based on above goals and standard BU student evaluation worksheets completed by supervising resident and all FM inpatient attendings for the 4 week rotation.
  • Summative evaluation by course instructor, Rebecca Juliar, pager#8944 will be reviewed with student in mid-rotation feedback and at the conclusion of the rotation

 

Guidelines for Absences

Students are reminded to maintain standards of professionalism, courtesy and common sense when scheduling residency interviews that take place during fourth year rotations.  Try to schedule interviews during vacation blocks whenever possible. In general, a student may, with advance permission from the rotation director, be away for no more than four days during the four-week rotation.

 Please take note of the following guidelines:

  • Students must work a minimum of two continuous weeks with no absences in order to pass the rotation.

 

  • If a student is absent for more than four days, those missed days must be made up in order to pass the rotation.  In some cases, a student may be required to repeat the rotation.

 

  • Students follow the holiday/vacation schedule of the team, not of Boston University.  Speak with the rotation director prior to making any travel arrangements during the rotation.

 

ELECTIVES IN FAMILY MEDICINE

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.

 

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.

 

 

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.

 

033.1  Title: Latino Health Elective

Department of Family Medicine

Boston University School of Medicine

Administrative ContactFlorence Laforest

Email address – flafores@bu.edu

Course DirectorElizabeth Ferrenz

Email address – Elizabeth.ferrenz@bmc.org

 

Clinical Faculty – may vary depending on availability each block

Carol Singletary, Registered dietician, EBNHC

Dr. Sonia Ananthakrishnan, Endocrinology

Dr. Jose Betances, Pediatrics

Dr. Charles Bliss, Gastroenterology

Dr. Miriam Hoffman, Family Medicine

Dr. Jessica Levi, Pediatric Otolaryngology

Dr. Jose Romero, Neurology

Dr. Peter Smith, Chronic Disease Education and Management (CDEM), EBNHC

 

NUMBER OF STUDENTS: One fourth year medical student

LENGTH OF ELECTIVE: 4 weeks

AVAILABLE BLOCKS: 14, 17, 18 and 19

 

SUMMARY

The Latino Health Elective is geared towards students with an intermediate-to-advanced level of Spanish who want a focused experience caring for Spanish speaking patients and studying the health of Latino communities.  To participate, students should be able to take a history and conduct a physical examination in Spanish.  Students will work in a variety of clinical settings including outpatient primary care, chronic disease management clinic, and specialty care.  Students will explore health disparities, as well as educate themselves regarding barriers to health care and community resources available to Latino patients throughout Boston.  During the four-week rotation, the student will be expected to investigate and present a topic agreed upon with the course director. 

You must contact the course director before signing up for this elective to determine the appropriateness of the elective for you and your level of Spanish proficiency.

 

DESCRIPTION OF ELECTIVE

The Latino Health Elective is an opportunity for fourth year medical students to improve their ability to provide medical care in Spanish, to increase their understanding of Latino health issues and disparities, and to research a topic of relevance to the health of Latino communities.

The elective experience will take place at East Boston Neighborhood Health Center (EBNHC), Boston Medical Center, and Boston area community agencies. 

Students will participate in clinical sessions in Family Medicine and Chronic Disease Management at EBNHC.  Specialty clinical sessions will take place at BMC.  Students will be responsible for conducting history and physical examinations in Spanish and presenting their findings in standard oral presentation format in English. 

At community agencies, students will learn about outreach to the Latino community around issues of immigration, housing, education, and more.  Latino elder care will be explored with an adult day health program.

Selected readings will be provided to students to expand their knowledge of Latino communities in the United States and health disparities facing Latinos.  These readings will be reviewed independently and discussed with the course director.

During the four week rotation the student will select a topic of interest relevant to the Latino community and prepare an oral presentation to be shared in the final week. 

Students will be evaluated on the basis of their participation in clinical sessions and engagement with community agencies and independent readings.  The final presentation will be evaluated on the basis of relevance to Latino health and skills in oral presentation.

Students must contact the course director before signing up for this elective to ensure that their level of Spanish proficiency will be adequate for a successful experience on this rotation.

 

OBJECTIVES

By the end of the Latino Health Elective, the BUSM student will be able to:

-          Improve her/his proficiency in providing medical care in Spanish (B, C, A)

-          Assess her/his own ability to provide medical care in Spanish and identify how to continue to improve this capability (B, C, A, E)

-          Define the role of interpreters in clinical encounters (C, S)

-          Describe the most significant health disparities affecting selected Latino communities (R, E, S)

-          Explain the barriers Latino communities face in the United States healthcare system (R, E, S)

-          Discuss available community resources for Latinos living in the Boston area (S)

-          Describe particular challenges faced by Latino elders (U, R)

-          Present project on a health topic of relevance to the Latino community (C, R, E)

 

CURRICULUM

The curriculum includes (see also separate document with the block’s template):

-          Clinical sessions – two sessions each week at EBNHC Family Medicine, one session each week in specialist clinics at EBNHC or BMC, chronic disease management individual and group visits twice a block at EBNHC, interpreter services session

-          Community agencies – two sessions each week with community based groups serving Latinos

-          Literature review – topic selected jointly with course director in second week of the clerkship with time provided for investigation throughout block and oral presentation in fourth week

-          Language skills – up to one session each week can be devoted to independent Spanish language study, course director has available languages books for loan and recommendations for conversational practice opportunities

-          Selected readings – provided at start of the clerkship for independent reading and analysis followed by  discussion with course director; this discussion will allow the course director to assess your understanding of the material and will be a component of your evaluation:

 

 

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: Two 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.