Description

The Family Medicine elective is a subinternship designed to incorporate fourth-year medical students into the Mayo Clinic Family Medicine Residency – Mankato clinical care teams and consists of both inpatient and ambulatory experiences.

Students spend three weeks in the Mayo Clinic Health System (MCHS) Mankato Eastridge Family Medicine continuity clinic, where the student is partnered with residents and faculty each half day. Students also spend one week on the Inpatient Service at MCHS – Mankato Hospital campus. Family medicine residents work with hospitalists and family medicine faculty during this rotation. Medical students assume primary responsibility for the patients they admit to the teaching service.

Specific goals

1. Gain an understanding of family medicine in the inpatient and outpatient settings.
2. Evaluate family medicine as a possible career choice.
3. Assess and manage the most common chronic diseases and health promotion (for example, women’s reproductive health, weight management, cardiovascular disease, hypertension, diabetes, mood and substance use disorders.)
4. Refine history-taking and physical examination skills.
5. Set an agenda with patients to prioritize their concerns.
6. Identify the appropriate timeline for testing, treatment, and follow-up.
7. Locate and describe recommended screenings for specific patient demographics and conduct risk-benefit discussions.
8. Perform common office procedures (for example, skin biopsies, pap tests, large joint injections)
9. Efficiently document outpatient clinical encounters addressing multiple acute and chronic conditions.
10. Develop definitive care plans in an inpatient setting.
11. Observe how the practice of family medicine is integrated into the spectrum of care delivered by a regional health system.
12. Obtain introduction to practice management skills in an inpatient setting, with respect to documentation, billing, coding, and other aspects.

Activity outline

• Students are paired one-on-one with a faculty or senior family medicine resident where they are expected to see two to three patients per half-day.
• Students are expected to review the person’s chart, independently perform the history and physical, formulate a differential diagnosis, diagnostic/monitoring plan, therapeutic plan, and identify recommended preventive health screenings.
• The student will discuss the management plan with their supervising physician who will also see the patient. Students will discuss recommended testing and treatment with patients.
• Students will have opportunities to perform procedures.
• Students will write a progress note on each patient that they see.
• Attend daily rounds on the Inpatient Service, as well as teaching huddles in the residency clinic.
• Complete comprehensive history and physical examinations on patients admitted to the inpatient service and develop comprehensive assessments, differential diagnosis, and treatment plans.
• Present patients each morning on rounds, as well as follow assigned patients through the entire course of care.
• Attend all applicable conferences and resident seminars while on inpatient or outpatient services.

Method of evaluation

Students are encouraged to share their learning goal(s) at the start of each clinic session. Students will be given in-the-moment feedback, feedback at the end of each clinic session, via the electronic medical record, and by written evaluation at the end of the rotation.

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.