Family & Preventive Med (FPMD)
A six-week, six-credit-hour required clerkship in the third year. Students care for ambulatory patients under the supervision of faculty members and residents for two weeks in the Family Medicine Center at Palmetto Health Richland or the Center for Family Medicine at Greenville Memorial Hospital. Ultrasound technology is available at both campuses and is utilized during this part of the clerkship. Students participate for two weeks as integral members of a team that provides care to hospitalized patients on the family medicine inpatient service. In these settings, students perform initial work-ups on new patients and care for patients with acute and chronic problems; they also have the opportunity for collaboration with nurses, nurse practitioners, and other health professionals. In addition, all students spend two weeks in the office of a practicing physician where they experience health care delivery as it is provided in a community family practice. A variety of settings is utilized from rural sites to suburban and urban sites. Primary methods of instruction include lecture, case-based discussion/presentation, computer-assisted instruction, clinical preceptorship, problem-solving exercises, conferences, standardized/simulated patients, small-group discussion, and teaching rounds. Modes of assessment include the Family Medicine NBME subject examination, clinical evaluations, and an Objective Structured Clinical Examination (OSCE). Demonstration of mastery of a prescribed set of clinical skills, included on the Clinical Skills Attainment Document, is required for successful completion of this clerkship. Demonstration of mastery of the following clinical skills is strongly recommended during this clerkship: participation in the nutritional assessment of a patient; observation and performance of outpatient dermatologic procedures; observation of a colposcopy and endometrial biopsy; observation of exercise stress testing; observation of a nasopharyngoscopy; and observation of an individual or family psychotherapy session.
A four-week, four-credit hour required clerkship in the fourth year. Students are required to complete the Acting Internship (AI) in one of the following: Family Medicine, Internal Medicine, Pediatrics, Psychiatry, Obstetrics and Gynecology, or Surgery. The AI emphasizes basic generalist competencies, is predominantly an inpatient experience, and includes night call. Acting interns are essential members of the ward teams, although students’ patient loads can be adjusted according to their aptitude. Some of the selectives also provide a minor amount of ambulatory clinical learning. The student has primary and direct responsibility for the continuing care of patients in the community or in one of the University of South Carolina School of Medicine programs at Palmetto Health Richland, the Dorn Veterans Affairs Medical Center, or the Greenville Hospital System University Medical Center. Alternatively, a student may elect to complete the AI as an extramural rotation but must have prior approval for this rotation from the USCSM AI director. The primary mode of instruction is clinical preceptorship. Other educational material may be presented via attending rounds, didactic lectures, subspecialty lectures, weekly grand rounds, resident case presentations, rounds with residents, clinical pathologic conferences, etc., and is dependent upon the specific rotation. Assessment will focus on core clinical skills, including, but not limited to, history and physical examinations, clinical decision making, case presentation, communication with patients, test selection and interpretation, and therapeutic decision making.
This course offers a brief, intensive exposure to a typical family practice, both for students considering a career in this area and those who are entering other specialties but who want to learn more about the role of the family physician in health care delivery. Students may be placed in rural, suburban or urban practices in various locations in the state, according to their preference. The practice exposure shall include ambulatory care of patients of all ages, including pediatrics, and inpatient hospital experience. It is important that arrangements be made for selecting the practice site as early as possible, and in no case with less than 6 weeks lead time. Preceptors shall be selected carefully and screened according to criteria formulated by the faculty of the Department of Family and Preventive Medicine.
This course is designed to give the fourth year medical students exposure to the different aspects of primary care sports medicine. Clinical venues include the Sports Medicine Center, Family Medicine Center, student health center, community settings and USC athletic training room. During the rotation, students will also gain exposure to physical therapy, casting/splinting and exercise physiology. Course Objectives: Improve musculoskeletal medicine knowledge base including anatomy, biomechanics, pathophysiology of common injuries, and prevention techniques. Improve musculoskeletal examination skills. Understand appropriate referral indications. Understand appropriate diagnostic tests, what and when to order, as well as how to read the studies. Understand treatment options for common musculoskeletal injuries. Improve treatment skills including common physical therapy protocols and therapeutic modalitites. Exposure to common musculoskeletal procedures including bracing and casting techniques, fracture and dislocation reductions, joint injections and aspirations. Didactic sessions occur weekly. Opportunities for additional didactics may occur throughout the rotation. Sporting event coverage takes place through the University of South Carolina as well as several local high schools. The rotation takes place in the setting of a Primary Care Sports Medicine Fellowship at a major NCAA Division I university. Students are offered the opportunity to work with both faculty members as well as sports medicine fellows. Requirements for the rotation include coverage of at least 2 sporting events with either Family Medicine residents, Sports Medicine Fellows or faculty members. In addition, students will be expected to give a 10 -15 minute presentation on a sports medicine topic of interest during one of the weekly didactic sessions.
This elective is designed to offer the student an intensive rural family medicine experience. The student will have a "hands on" experience working with patients in the office of a small town family physician. During this time, the student will be precepted by the community physician and learn first hand of the unique problems these physicians face in the delivery of health care in a rural setting. The student will have the opportunity to learn the benefits of a team approach to health care through interaction with nurse practitioners and other health care professionals. The student will also acquire first-hand information about the lifestyle of primary care physicians in the rural setting and the impact they have on their patients and their community. Finally, the student will be introduced to practice management issues pertaining to private practice in a rural setting. The elective offers rotations in several small communities within reasonable driving distances from Columbia. Other sites are available which will allow the student to stay in the community to better experience the lifestyle of a small town physician. It is important that arrangements be made for selecting the practice site as early as possible, preferably with at least 6 weeks lead time.
The course is designed to provide introduction to and enhancement of office-based counseling skills in primary care. It will also address basic theory and skill development in the treatment of emotional disorders within the structure of a primary care practice. Emphasis is placed upon brief, direct, and supportive techniques and strategies intended to augment clinicians' abilities to effectively treat some of the most common psychosocial issues encountered in primary care clinics. Programmed videotapes will be presented and evaluated. Videotaped encounters of the student with Family Medicine patients will be monitored and individually supervised. Videotaping will address interview skills, relationship enhancement issues, transference and countertransference phenomena, nonverbal communication and patient psychodiagnostics. Students will be precepted within and and outside the Family Medicine Center by a variety of interdisciplinary clinicians. Students may sit in on individual and family psychotherapy sessions with the preceptors and discuss patient dynamics. Psychiatric topics of interest to the student will also be prepared and discussed.
This course offers a brief, intensive exposure to Global health. It is intended for students considering a career working in this area, as well as for those who plan to spend the majority of their career in the United States but want to learn more about providing clinical care in developing nations. The first two weeks of the elective will be spent in the United States with significant didactic requirements, including readings, small group discussions, and required presentations. The latter two weeks will involve a project with the organization Shoulder to Shoulder. From their materials: “The Honduras field experience is set in rural Santa Lucia, Intibucá, at the Shoulder to Shoulder clinic. The clinic provides 24 hour service to the residents in the area including dental services, x-ray and lab services, maternity services and inpatient care. The clinic is an eight hour bus ride from the airport, and three hours over dirt roads from the closest hospital. Every brigade member will have a variety of experiences, including outpatient clinic work, overnight call in the clinic, public health projects, and home visits. Students and residents are supervised by faculty with experience in global health. Nightly conferences are held to discuss the events of the day, interesting cases and presentations by residents, students and faculty.”
The senior medical student will spend 40 hours per week for approximately 4 weeks. This elective will focus primarily on teaching the student various point-of-care ultrasound examinations and applications in both inpatient and outpatient settings. This includes but is not limited to: point-of-care echocardiography, evaluation of the IVC, aorta, and lung exams. Furthermore, the course will include MSK applications and ultrasound guided procedures. The student will perform a number of required examinations, attend family medicine ultrasound procedure clinic, and accompany family medicine resident physicians on the hospital wards for educational scanning. At the end of the rotation the student should be able to successfully complete each of the previously mentioned examinations and should be familiar with common primary care applications of point-of-care ultrasound.