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
030.1b Title: Sub-internship in Family Medicine
Instructor: Sara Karp, M.D.
Location: Tufts University Family Medicine Residency – Malden, MA and Lawrence Memorial Hospital – Medford, MA
Number of Students Per Block: One
Period to be offered: Check for availability (contact Florence Laforest)
Housing is not available.
Description of Elective: Students will participate in the adult inpatient teaching service at Lawrence Memorial Hospital in Medford, MA, a principal teaching institution for the Tufts University Family Medicine Residency Program. Students will function as subinterns under the supervision of family practice interns and residents. A critical care fellow may also work with the student in the ICU. Both Internists and Family Practitioners will be admitting patients to the teaching service and conduct work and teaching rounds. Responsibilities will include all aspects of inpatient care including evaluation of the patient, completing histories and physicals, rounding, and order and note writing. There are daily didactic lectures including videoconference links to the residency site. A night float system covers Sunday-Thursday nights 7:00 pm – 7:00 am. Therefore the medical student will be on call 1-2 weeknights each week until 8:00 pm. The student will have two weekends off and two weekends working overnight Friday and all day Sunday until 8:00 pm.
This elective is offered to Boston University students only.
Note: This elective satisfies the sub-internship 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: Christine Pecci, MD
Location: Boston Medical Center
Number of Students Per Block: One
Period to be offered: Blocks 9 – 19
Description of Elective:
The purpose of this elective is to give students a family-medicine-centered experience which includes prenatal care, perinatal care including labor and delivery, and inpatient postpartum care for women as well as newborn nursery care for their infants. The student will spend mornings on the inpatient floor caring for postpartum women and their infants and focusing on issues such as breastfeeding, the newborn exam, routine postpartum care, maternal counseling and anticipatory guidance. Afternoons will be spent either seeing primary care patients [with a focus on prenatal and pediatric patients] in clinic, researching and/or reading about a maternal/child health project which will be presented at the end of the elective, or on the labor and delivery floor. There will be several [1-2 per week] extended stretches of time on the labor and delivery floor to increase the student’s likelihood of being actively involved in deliveries; occasionally these calls may include weekends. The exact schedule for each elective will be determined with the student prior to the start of the elective, and it will be offered during selected blocks. Boston University students: for information or to register, please contact Florence Laforest in the Dept. of Family Medicine by calling (617) 414-6237.
030.1c Title: Elective in Family Medicine – Central Maine Medical Center
Instructor: Edmond Claxton, 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.
030.1e Title: Family Medicine Elective – Boston Medical Center
Instructor: Salvatore J. Molica, Jr., M.D., M.P.H.
Location: Family Medicine Center, Boston Medical Center, Boston, MA 02118
Number of Students Per Block: one
Period to be offered: Blocks 10, 11, 12 and 13
Housing is not available.
Description of Elective: Students will see ambulatory patients at one of the affiliated residency sites, including South Boston Community 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 be assigned a faculty preceptor with whom he or she will meet frequently. 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. Please contact Florence Laforest
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 5- 8 (third year students); Block 9-20 (fourth year students)
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
Instructor: Alysia Green, M.D.
Contact: 414-6235
Location: BMC, BU Ryan Athletic Center and various athletic fields at events
Number of Students Per Block: one 4th year B.U. medical student
Period to be offered: Blocks 13, 17 and 18
OBJECTIVE: To gain exposure and experience in the field of primary care sports medicine
GOALS
- Increasing skills in primary care medicine
- 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
Shawn Ferullo, M.D.-Family Medicine/Primary Care Sports Medicine
Douglas Comeau, D.O-Family Medicine/Primary Care Sports Medicine
ADDITIONAL FACULTY
Larry Venis, Head Athletic Trainer, Boston University
Mark Larson. Head Athletic Trainer, Boston University
Tom Cronan, Head Athletic Trainer, MIT
Amanda Nicoles, Head Athletic Trainer, Pine Manor College
CURRICULUM
The curriculum will include experiences in both primary care and primary care sports medicine. A sample of a weekly schedule of clinic time and other experiences would be the following:
-3 half days of Primary Care Medicine
-5 half days of Primary Care Sports Medicine
-1/2 day of Sports Medicine Conference followed by experience in the Athletic Training Room at Pine Manor College, Boston University or MIT
-1/2 day of reading time
-Game coverage: will vary depending on the time of year and block done but anticipate at least 1-2 game coverage opportunities per week of the elective
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 one hour presentation based on a sports medicine case that they observed during the rotation. They will further be evaluated throughout their rotation on their musculoskeletal examination skills.
