Description

This elective is designed to involve the third- or fourth-year medical student in the daily activities of the residency’s Family Medicine Teaching Service. FMTS is a team that provides medical care in the inpatient setting. Its patient population is primarily adults but at times will include pediatric patients as well as pregnant patients and newborns. Most patients admitted are from the residency’s patient panel, however, other patients are accepted as needed to meet educational objectives.

Students will spend one to four weeks working with a team including a senior (PGY-2 or PGY-3 resident) and attending family medicine faculty member. During most of the year, it also includes a PGY-1 resident. The goal is for the medical student to function as a first-year resident under the direct supervision of the senior resident with support from both the resident and faculty attending.  

Specific goals

1. Gain an understanding of family medicine in the inpatient setting providing care for all ages from birth to death.
2. Develop definitive care plans in an inpatient setting.
3. Refine history taking, physical examination, as well as assessment and management skills.
4. Observe how the practice of family medicine is integrated into the spectrum of care delivered by a large multispecialty institution.
5. Evaluate family medicine as a possible career choice.
6. Gain background information about the selection of a family medicine residency.
7. Obtain introduction to practice management skills in an inpatient setting, with respect to documentation, billing, coding, and other aspects.
8. Develop skills in the management of patients with a wide range of conditions as defined by The Society of Hospital Medicine Core Competencies.

Typical day

The following is an outline of a typical day within the FMTS:

• 7-7:15 a.m. – Sign-out rounds following the IPASS format occur in FMR Team Room 14. This includes all residents, medical students, and faculty attending.
• 7:15-9 a.m. – Individual resident rounding time including chart review, review of morning labs and nursing notes, and in-person rounding. Please note that residents and students MAY need to begin their workday with chart/lab review before 7 a.m. sign-out in order to complete needed work before group rounds occur.
• 9-10 a.m. – Team rounding to include a combination of bedside and “table rounding." This will be a regularly scheduled time so as to allow the pediatric hospitalist and family medicine laborist to join if possible. The first 10 minutes on Monday are reserved for discussion of expectations and documenting individual and team goals for the week.
• 10-noon – Complete all time-sensitive tasks.
• Noon-1 p.m. – Lunch and noon didactics/meetings. In-person attendance is required in all but extraordinary circumstances.
• 1-5:30 p.m. – Completion of rounds, new admissions, documentation, etc.
• 5:30-6 p.m. – Educational time. This is intended to be a short (15-30 min) session centered around patients/conditions seen during the week.
• 6-6:15 p.m. – Sign-out to night resident. includes all residents and students.  

Expectations

• The medical student is expected to work with the team Monday through Friday exclusive of holidays.
• Complete comprehensive history and physical examinations on patients admitted.
• Formulate comprehensive assessments, differential diagnosis and treatment plans for each patient admitted to the hospital service.
• Present patients each morning on rounds, as well as follow the patient through the entire course of care.
• Attend all applicable conferences and resident seminars while on the FMTS.

Method of evaluation

Faculty members evaluate medical students based on clinical skills, knowledge, and timely completion of tasks. These include establishing a therapeutic relationship, taking appropriate histories, demonstrating appropriate physical exams, describing clinical findings, developing a differential diagnosis, formulating a plan and conveying your recommendations to the team and patient.

Per Mayo Clinic institutional policy, faculty and residents/fellows will not complete any outside evaluations. You will be provided with an electronic performance evaluation via Mayo Clinic’s MedHub portal. A final summative evaluation will be sent to you and your school official upon completion of your clerkship.