Department of Family Medicine
Medical Student Education Course Descriptions

Clerkship: Small Group Leader
3 half days per block

These sessions focus on two hypothetical families, the McQs and the Riveras. Members of the three-generation McQ and Rivera families have their own patient charts dating back five years which students review, and family members are followed through a series of problem-based scenarios. Group leaders are needed for these small group discussions, which cover readings and interviews, the diagnosis, treatment, and management of many problems commonly encountered in the outpatient setting. This is an interesting and lively interactive discussion group. It offers the opportunity to work with the same group of students for 3 sessions over the course of their FM clerkship. 

New this year: This year we are increasing the focus on looking up point-of-care EBM questions in real time during small group.  This will provide direct application of the skills the students learn in our Information Mastery curriculum.  We will provide faculty with the information needed to support this.
Small groups are generally on Mondays and Tuesdays.

Clerkship: Patient Interview Observation
1 half day per session

Students interview McQ and Rivera family members, represented by actors/standardized patients. Students prepare for these interviews through a series of readings and discussion groups led by faculty in the department (the small groups). Faculty will observe student interviews and facilitate a discussion/debrief.  Topics covered include: motivational interviewing, giving bad news, identifying mental health concerns, and working with interpreters.

New this year: the Mike McQ SP session will be 1 hour long and will include an interactive, structured curriculum in motivational interviewing. 
These sessions generally occur on Monday afternoons.

Clerkship: OSCE Observation
1 half days per session

The OSCE (Objective Structured Clinical Examinations) will be with one of the McQ or Rivera family members. Students have approximately 20 minutes to conduct an interview and discuss their management and follow-up plan with the actor/patient. The interview is observed by a faculty member via video camera and graded on a checklist.  The faculty gives short feedback to each student when he/she is done. 
This is usually on Friday morning.

Clerkship: Progress Note Grader
1 half day per block

The student will write a SOAP note based on the OSCE interview, which addresses the following items: appropriate history, assessment, plan, treatment, patient education and follow-up. The progress note is graded using a checklist.

The graded progress notes must be returned to clerkship staff within the assigned timeframe (2 weeks).

You can do this work at whatever hour of the day works for you, so it provides flexibility in teaching time scheduling.

Clerkship: Geriatrics Seminar
1 half day per block 

Students meet as a group (10-12 students) with a facilitator for the 2 hour workshop.  The first hour consists of a lecture/discussion on common geriatric screening tools: the MMSE, Geriatric Depression Scale, ADL and IADL Scales and the Get-Up-and-Go Test. Students are asked to use the tools twice during the clerkship and on a home visit.

The second hour is an interactive exercise on advance directives. Students view an interview of a family doctor having a discussion with a patient. The interview is shown in 5 segments, each segment is discussed separately, with both content and communication techniques addressed. The students are then asked to take home an instructional advanced directive to complete on themselves or someone else for discussion in the next small group meeting.  The 2 hour workshop will be taught twice in a row.

This session generally takes place on Tuesday afternoon.

Clerkship:  Acute Presentations Workshop Leader
1 half day per block

This session is held in the Clinical Skills and Simulation Center.  Students manage an acute outpatient emergency as a group.  The patient is the high fidelity full body simulator (a mannequin that has vital signs, physical findings, can speak etc).  Faculty observe the student group managing the patient, and discuss/debrief the clinical scenario midway through the session and at the end of the scenario. 
This session is generally on Tuesday afternoons.

Clerkship: Information Mastery Workshop
0.75 half day per block

Faculty will lead this interactive workshop for the clerkship students (22-24 students per block).  The session with instruct them in the skills of information mastery – using EBM in an effective way at the point of care and utilizing patient oriented (as opposed to disease oriented) outcomes. 
This session is generally on a Monday afternoons.

Clerkship: Acute Respiratory Infection Workshop 
0.75 half day per block

Faculty will lead this interactive workshop for the clerkship students (22-24 students per block).  Students will be split into 3 groups to work on 3 different cases of patients with acute respiratory infections.  The groups will present their cases to the group, and then a short, informal didactic session will take place teaching main points of different respiratory illnesses.  Finally the students will go back into their groups, and using the information mastery skills that they just learned, answer more advanced questions on evidenced based next steps/treatment for their cases and present their findings to their peers. 
This session is generally on a Monday afternoons.

Clerkship: Physician Wellness
0.5 half day per block

Faculty will facilitate this interactive 1 hour lunch session on physician wellness.  The session is structured to review statistics on physician burnout, depression, divorce, etc.  Students generate a list of qualities of their mentors and antimentors and then an interactive discussion takes place about the concept of identifying values, and lining up those values with future personal and career steps, to achieve happiness and wellness.  The groups will be 10-12 students. 
This will usually take place on Mondays at lunch. 

Clerkship: Home Visit Report Grader
1 half day per block

At the end of the clerkship, each student will submit a report containing the information they learned about their home visit patient.  This year we are changing this assignment so that it is a guided checklist rather than a narrative report.  This will make grading it easier. 

The graded reports must be returned to clerkship staff within the assigned timeframe (2 weeks).

You can do this work at whatever hour of the day works for you, so it provides flexibility in teaching time scheduling.

End of Third Year Assessment (EOTYA)

IP 1&2 Fall & IP 1 Spring
5 half days

The Integrated Problems Course is a problem-based learning course taken by all BUSM medical students throughout their first and second years. Students meet in groups of 6-8 with a faculty facilitator for 2 hours per week to consider learning issues raised in discussion of a case. These paper cases are based on actual patients seen at Boston Medical Center and its clinics. Students discuss a section of the case in depth, then select issues they would like to research. They spend a week researching the issues they have chosen. The students then report their information to the group at the next meeting and then go on to consider the next portion of the case. The cases are written to encourage the students to integrate and expand the knowledge they are gaining in their other courses. The faculty facilitators guide and question as needed in the sessions but are not sources of information or teachers in the usual sense. The course has been very successful. Facilitators and students enjoy this mode of teaching and learning.

Training of facilitators will be scheduled prior to start of course. The training, which is a prerequisite for teaching, requires about four hours plus additional orientation session just before the term begins. Participation in training sessions is required.

In the course itself, the sessions are two hours long. They are held once a week during the fall and spring terms. There are 10 to 12 sessions in each term. There is a choice of term, day and time for teaching. There is a meeting of the facilitators during the term, usually over lunch, to discuss questions or problems with the course directors and other facilitators, and to report on progress.

ICM 1 Small Groups - Fall
4.5 half days

The purpose of this course is to provide instruction in basic medical interviewing skills to weekly small groups of First-year Medical School students. You will be assigned a group of 4-9 students. The student interview generally takes 2 hours. You will observe each student on your team perform at least one interview during the course (if you have a smaller group of 4 students, each student should be able to perform 2 interviews). The student will be required to present the case and facilitate a group discussion about the interview and patient. At the end of the course you will be required to do a written evaluation for each student.
By the end of the course, the First-year Medical School student will be able to:

  • Initiate the interview by informing the patient of their name and about their role as a medical student (or student doctor)
  • Communicate the purpose of the interview by asking what the patient has been told about the interview, then stating the length of the interview and explaining that the interview is a learning experience for the interviewer and the group, as well as an opportunity for the patient to tell his or her story
  • Inquire about the patient’s chief complaint
  • Gather the necessary patient information, using open-ended and closed-ended questions.
  • Develop a rapport with the patient.
  • Identify the patient’s mental state, including understanding the patient’s cognitive capacity and ability to process information.
  • Terminate the interview by both summarizing briefly some of the main points and expressing your gratitude for the patient's contribution to your education.
  • Organize the data from the interview and make a brief oral presentation to their peers and the instructor.
  • Complete a brief write up of the interview including the following key elements; introduction data (name, age, and gender), chief compliant, source of history and reliability, and a history of present illness.

ICM 1 Small Groups - Spring
4 half days

The ICM 1 spring course consists of lectures, Small Group sessions, online modules, 10 longitudinal clinical sessions and an OSCE.

SMALL GROUPS: There are 7 Small Group sessions. The course is "frontloaded" with PE skills before they go off to their clinical sites. Group sessions are used for teaching/practicing very basic normal clinical skills (BP, HEENT, cardiovascular, abdomen) . In addition students will do one Cultural awareness exercise in February and will present cases from their sites in later sessions. There is a faculty development session in November to review the course and materials in detail. In addition, there will be optional faculty drop in sessions in the hour or so before group or lecture time to review skills teaching and talk about what is going on in their groups.

Small Group dates for 2013-2014, ALL are THURSDAY AFTERNOONS:
*dates have 2:45 start time. Others may start @1:30

  • December 5*
  • December 12
  • January 9
  • January 16
  • February 20*
  • March 27*
  • May 8

ICM 1 Spring Clinical Shadowing
2 half days

Introduction to Clinical Medicine is based predominantly in primary care settings where student to faculty ratios are as small as 1:1. In the first year, the students explore both the various aspects of the doctor-patient relationship and the relationship of medicine to some of the broader, social issues of our time. Under the guidance of an experienced physician, students interview patients, addressing specific sensitive issues such as sexuality, substance abuse, domestic violence, and aging. The Department of Family Medicine directs one of the sub-options in the first-year Introduction to Clinical Medicine course. Each student is placed in a family physician's office for twelve sessions over the spring semester. This one-on-one mentoring program allows students to directly observe and participate in patient care in an outpatient setting in a family physician's office. Students are able to start learning the skills involved in interviewing and examining patients while developing a relationship with one physician in the community. In addition to going out to offices, students are invited to attend a series of workshops where they learn how to take vital signs, use ophthamoscopes/otoscopes, approach well childcare and a variety of other topics.

ICM 2 History and Physical Exam (HPE)
5 half days

These sessions are designed to give second year medical students experience in doing complete history and physical examinations. By the end of the four sessions, each student will have done four complete HPE (History and Physical Examinations). Students should receive their patient assignment, do the work-up in the morning, prepare for presentation in the midday, then meet with the instructor for approximately two hours in the afternoon.

Each instructor will be assigned two students. Each student will orally present his or her case. (NOTE they have never done this before.) Then the team should go to the bedside to review historical or physical exam data. Students are asked not to look at the patient's chart before presenting the case. Although the team may decide to review the chart, lab data, or radiographs, the focus should remain on the history and physical exam data.

The next task is for the student to write the HPE in the standard format. (Their BU Handbook has details, and students receive a sample hand-written write-up). The Boston University History and Physical Examination paper should be used as it has a wide comment margin. (It is available in Dr. Stanfield’s OME office at the medical school). The write-up should include all the traditional parts, such as source of information, a complete review of systems, and a problem list based on the results of the patient examination. It does not need to include an assessment and plan section as this area is expanded upon in the third year. By mailing or bringing the write-up to the instructor as soon as possible, (in most cases it should be completed before leaving the site for the day), the student should be able to have the critiqued paper handed back at the start of the next session. In this way improvements can be made to subsequent write-ups.

By the end of ICM-2, students are expected to have the clinical skills necessary to start their third year clerkships. More specifically; students should be able to take a complete medical history that is sensitive to patients' emotional needs and personal backgrounds, perform a complete physical examination except for the breast, genital and rectal exams, record the data in the standard medical format, and verbally present the findings in an organized fashion.

Healers Art- 1st/ 2nd year winter elective
5 half days

“The Healer's Art” is an elective for first and second year medical students. The course was developed originally by Rachel Remen, MD at UCSF in 1993. The Healer's Art has been replicated throughout the country: in 2004-05 it will be offered at 35 U.S. medical schools. The course’s educational objectives include reinforcing the human dimensions of the student physician, preventing “burnout,” providing self-care tools for processing grief and loss, and strengthening the students’ sense of personal mission and meaning for their career in medicine. The Healer's Art is a 15 contact-hour course consisting of five three-hour evening sessions spaced two weeks apart, usually running from January to March. The sessions are divided into large-group and small-group experiences. Depending upon student interest, there can be from 10-50 students enrolled. The session topics are:

  • Discovering and Nurturing Your Wholeness
  • Sharing Grief and Honoring Loss I
  • Sharing Grief and Honoring Loss II
  • Beyond Analysis: Allowing Awe In Medicine
  • The Care of the Soul

Workshops employ both didactic and experiential learning. A typical session consists of a “seed” lecture by the course director to the entire group of students and then subsequent small group discussion. The small groups consist of 5-6 students and 1-2 faculty facilitators. The membership of each small group is held constant throughout the course and provides a safe environment for students and physician facilitators to discuss sensitive issues and experiences. A decade of student evaluations at other medical schools have been uniformly exceptional, describing the experience as unique in their professional training. Faculty evaluations suggest that the course also has profound effects on the faculty as well. Many students continue to maintain contact with the course director and other faculty members for the remainder of their medical school training and on through their residency years. The Healer’s Art course director, Rob Saper, MD MPH, was a faculty facilitator for the course at UCSF in the 1990s. Department faculty are needed to facilitate the small groups. A commitment to attend all five evening sessions and one orientation is required. Please speak with Dr. Rob Saper if you have any questions or would like more information.

Healers Art- 3rd/4th year longitudinal elective
0.75 half days per session

This year we will be piloting a longitudinal Healer’s Art course open to all 3rd and 4th year students. This will occur every 6-8 weeks, and students can attend as many or few sessions as they are able.  The activities will be geared towards students in their clinical training years. Dinner will be provided.