Florida State University (College of Medicine)

At the Florida State University College of Medicine, we’re interested in producing doctors who are caring practitioners of both the art and science of medicine. That process starts with choosing the right students - people who will work well with their patients and the entire health-care team. After carefully selecting our students, we immerse them in a culture that embodies the characteristics we expect to see in our graduates. Throughout their education, FSU medical students learn in an environment that values diversity, mutual respect, teamwork and open communication. They also actively participate in an innovative curriculum that prepares them to become lifelong learners in an era of explosive growth in medical knowledge and information technology.

The FSU College of Medicine focuses on educating outstanding physicians for practice in community settings.

Students benefit from a well-structured continuum of education in the biomedical, behavioral and clinical sciences. Subjects such as anatomy and pathology are presented in a clinically relevant context using medical cases, as well as the latest educational technologies. Problem-based and small-group learning experiences help students develop their clinical acumen and learn to work as a team.

Community-based clinical education spans the four-year curriculum. During the first two years, students’ clinical education takes place in physician practices in the Tallahassee area, as well as in the medical school’s Clinical Learning Center. In the third and fourth years, students complete their required clinical rotations at one of the medical school’s four regional campuses, located in Orlando, Pensacola, Sarasota and Tallahassee. In these urban centers and the surrounding rural areas, the clinical training program extends into hospitals, skilled nursing facilities, managed care organizations, private clinics and other outpatient settings.

The curriculum is comprehensive, preparing students for any medical specialty and setting. Course content reflects the college’s mission, with special attention given to primary care, geriatrics, cultural diversity, and the needs of underserved populations. In addition, concentrated learning opportunities are offered for those students interested in rural health. All courses make use of the latest instructional technology, and medical informatics is integrated throughout the curriculum.

The Florida State University College of Medicine will educate and develop exemplary physicians who practice patient-centered health care, discover and advance knowledge, and are responsive to community needs, especially through service to elder, rural, minority, and underserved populations.

The FSU College of Medicine will lead the nation in preparing compassionate physicians to deliver the highest quality 21st Century patient-centered medicine to communities of greatest need.

The Florida State University College of Medicine carefully selects students who are outstanding academically and are committed to the college's mission of service to Florida's medically underserved populations. FSU medical students come from all over Florida and are culturally diverse. Many come from small towns and rural areas, but the state's major metropolitan areas are also well represented. A number of students are older than average for medical school and bring a broad range of professional and life experiences, while others come straight out of undergraduate programs. Most are active in student organizations, community service projects and medical outreach programs.

The Clinical Learning Center (CLC) is a state-of-the art teaching and assessment center that provides opportunities for medical students to learn clinical skills in a simulated clinical setting. Twelve examination rooms and one interview room are equipped with the latest in clinical and audio visual equipment to allow students to learn and practice in a non-threatening environment.

Standardized patients are community members who are hired to portray specific medical and psychosocial problems for Clinical Learning Center & Standardized Patient Programthe medical students' practice and evaluation. Students use standardized patients to practice skills such as:

* obtaining a medical history,
* conducting an appropriate physical examination,
* documenting findings,
* developing treatment management plans and
* counseling patients.

Activities in the Clinical Learning Center can be videotaped for learning and assessment purposes. In addition, training simulators and mannequins are used to teach such clinical assessment and intervention skills as heart, lung and bowel sounds, venipuncture and catheterization.

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College of Medicine Medical School Location

College of Medicine Courses

YEAR 1 COURSES :

* CLINICAL ANATOMY/EMBRYOLOGY/IMAGING : Human Anatomy, Embryology and Imaging (BMS 6115) is a 10 week long course and runs concurrently with the Doctoring 1 Course. Because this is the first basic science course presented in the curriculum, its prime goal is to provide the students with a basic understanding of the gross anatomy, embryology and radiologic imaging of the entire body which will serve as a solid foundation for the remainder of the student's medical education and future profession. Second, this course was designed to prepare the student for the applications of anatomy and embryology to the clinical sciences, and for the application of radiologic imaging toward diagnosis of clinical disorders. Students will be stimulated to utilize learning resources such as faculty, textbooks, journals and FSU-COM computer resources. The course will also promote the development of student-directed problem solving skills to recognize an existing knowledge base and any gaps in that knowledge base that must be learned in order to understand the applications of clinical anatomy to clinical reasoning. Working in small groups studying clinical cases and studying in the laboratory will promote a team approach to learning. Students will utilize a variety of digital imaging programs that will supplement learning that occurs in the laboratory setting, lectures, small-group sessions and personal study time. As a side benefit, this course will introduce the student to anatomical terminology commonly used in medicine today. The anatomic knowledge learned in this course will be both applied and reinforced in later courses in the curriculum.

* DOCTORING 101: Doctoring I is the first component of a three year longitudinal curriculum with an educational mission of imparting to each medical student graduate the fundamental patient centered skills important in health and disease as the basis of safe and effective patient care.
Each year of the integrated curriculum has a unifying goal:
* Doctoring 1: Developing an appreciation of the basic
history and physical examination across the lifespan utilizing a biopsychosocial approach
* Doctoring 2: Developing clinical reasoning and advanced clinical examination skills incorporating the pathophysiological basis of common diseases
* Doctoring 3: Advancing clinical reasoning and applying clinical skills concepts and principles in the provision of medical care
Behavioral medicine, medical humanities, bioethics, information technology, and professionalism are incorporated throughout the curriculum to enhance understanding and development of clinical skills. Doctoring 101 will establish a broad framework for topics to be further addressed over the course of the year.

* CLINICAL NEUROSCIENCE: This course is designed to provide students with a fundamental understanding of clinical neuroscience. Students who complete this course will understand the normal anatomy and physiology of the nervous system and will recognize important symptoms and signs associated with neurological disease. In addition, students will understand the functional and clinical significance of the three-dimensional organization of anatomical structures, and the interconnections and spatial relationships that bind structures together in the nervous system. Mastery of these concepts will enable students to localize lesions in the central nervous system and predict the neurological deficits associated with lesions. Our goal is to achieve long-term acquisition of neuroscience concepts such that students perform well as clinicians long after the course has been completed.

* CLINICAL MICROANATOMY : This course provides a solid foundation in clinical microanatomy and cellular function necessary for subsequent learning about the microscopic pathophysiology related to clinical problems. All major tissue groups will be covered in the course. The course emphasizes relating tissue and cell structure to function. The course will be taught concurrently with Doctoring 101 and Clinical Neurosciences courses. The course will promote the development and use of student-directed problem solving skills to recognize an existing knowledge base and, more importantly, to identify gaps in that knowledge base that must be learned in order to understand the applications of this course content to clinical reasoning. This course will enable the students to apply their knowledge to learning pathophysiologic principles in later courses.

* CLINICAL PHYSIOLOGY : The medical students will study in detail the clinical physiology of organ systems and their integration into the whole body. Function and dysfunction will be studied and integrated with materials presented in Biochemistry, Anatomy (Gross and Micro), Neuroscience and Doctoring courses.
The course consists of 15 weeks (approximately85 total hours of contact time, 6 credit hours). A clinically based integrated organ system approach will be used, covering the: cardiovascular; pulmonary; renal; gastrointestinal and endocrine systems.

* MEDICAL BIOCHEMISTRY & GENETICS : Medical Biochemistry and Genetics is a five credit course offered in the third semester of the first year of the medical curriculum, concurrent with Doctoring 103 and Clinical Physiology. The course goal is to provide the foundation for producing graduates who are knowledgeable in the fundamental biochemistry and genetics of normal and abnormal body processes. Students will apply this knowledge to course discussion of the biochemical and genetic bases of common or representative diseases, including their symptoms and treatments. They will come to understand and be able to evaluate potential advances of diagnostic and treatment modalities. The content of this course provides students with a foundation upon which to build in second year courses, clerkships and graduate medical education. Student small-group learning experiences encourage professional behavior and teamwork in a context that promotes use of resources such as the library, faculty and information technology. Course topic scheduling is coordinated to prepare students for and reinforce topics in Clinical Physiology. The following list is illustrative of the educational objectives of this course.

YEAR 2 COURSES :

* GENERAL PATHOLOGY AND IMMUNOLOGY : The general pathology course in the Fall semester at FSUCOM covers the basic pathophysiology of mechanisms of disease in medicine. The knowledge gained from study of these basic mechanisms will be applied to systemic pathology in the Spring semester and to clerkships in the 3rd and 4th years. This pathology course will incorporate gross pathologic, microscopic, and radiologic material to assist you in understanding the disease processes and prepare you for licensing examinations. The knowledge gained from a study of pathology will integrate with other courses to provide you with the means for assessment and diagnosis of patients under your care.

* GENERAL MEDICAL PHARMACOLOGY : This introductory course deals with the concepts of pharmacodynamics (e.g., drug-receptor interactions, signaling mechanisms, and dose-effect relationships) and pharmacokinetics (e.g., drug absorption, distribution, metabolism, and elimination). The course emphasizes the biochemical and physiological bases for understanding drug action, and it introduces many major classes of drugs. Groups of drugs which are specifically considered include those acting on the autonomic nervous system, those most prominently affecting the immune system, and antineoplastic, antimicrobial, and antiparasitic compounds.
The course consists of 32 lecture hours, 3 clinical discussion-tutorial sessions, and 3 small group discussion sessions. The examinations for the course will be incorporated into the 3 integrated examinations for the 12 week Fall Semester. In addition, there will be 4 announced quizzes and a brief written critique which will be graded.

* GENERAL MEDICAL MICROBIOLOGY AND INFECTIOUS DISEASE : This course provides learning opportunities in the basic principles of medical microbiology and infectious disease. It covers mechanisms of infectious disease transmission, principles of aseptic practice, and the role of the human body’s normal microflora. The biology of bacterial, viral, fungal, and parasitic pathogens and the diseases they cause are covered. Relevant clinical examples are provided. The course provides the conceptual basis for understanding pathogenic microorganisms and the mechanisms by which they cause disease in the human body. It also provides opportunities to develop informatics and diagnostic skills, including the use and interpretation of laboratory tests in the diagnosis of infectious diseases.

* DOCTORING 201 : Doctoring II is a component of a three year longitudinal curriculum with an educational mission of imparting to each medical student the fundamental patient centered skills important in health and disease as the basis of effective patient care.
Doctoring 201 and 202 Courses bridge the gap between basic sciences and clinical medicine. These courses provide the basic knowledge and skills needed to evaluate patients while at the same time emphasizing the importance and integration of behavioral medicine, ethics, information technology, and professionalism. The course prepares the second-year medical student for clinical clerkships by developing a fund of knowledge and data-gathering skills. The basic elements of diagnostic reasoning are introduced.

* MEDICINE AND BEHAVIOR I : Human Behavior addresses the psychological and social basis of patient and physician behavior and the interrelationship between these factors and health, illness and the practice of medicine. The emphasis of the course is on better understanding of the psychological and social context of physicians’ and patients’ lives. Human Behavior covers basic behavioral science content with the goal of having the student be able to apply this fundamental knowledge base to clinical situations for more effective delivery of health care to both individuals and groups.
A variety of instructional methods are used including large group presentations, small group discussions and team based learning. A variety of panels of experts will help in the instruction.

* SYSTEMIC PATHOLOGY AND LABORATORY MEDICINE : Specific objectives accompany each lecture handout. The systemic pathology course in the Spring semester at FSUCOM covers the pathophysiology of disease in medicine by organ systems. The knowledge gained from study of these systems will correlate with other courses for each organ system in the Spring semester and be applied to clerkships in the 3rd and 4th years. This pathology course will incorporate gross pathologic, microscopic, and radiologic material to assist you in understanding the disease processes and prepare you for licensing examinations. The knowledge gained from a study of pathology will integrate with other courses to provide you with the means for assessment and diagnosis of patients under your care.

* SYSTEMIC MEDICAL PHARMACOLOGY : Building upon the principles learned in General Medical Pharmacology, students study in detail the pharmacologic agents used in treating disorders of organ systems. Drug classes, interactions, and specific usages with functional and clinical applications are presented with relevant clinical examples, including the use of therapeutic drug monitoring. Groups of drugs specifically considered include cardiovascular, respiratory, renal, gastrointestinal, hormonal, hematologic, analgesic, central nervous system, ophthalmic, and dermatologic agents.
The course consists of 47 lecture hours, 5 clinical discussion-tutorial sessions, and 2 two-hour small group sessions. Pharmacology content will also be incorporated into small group sessions in the Systemic Medical Physiology course. The examinations for the course will be incorporated into the 5 integrated examinations and the final comprehensive examination for the 25 week Spring Semester. In addition, there will be 5 announced quizzes which will be graded.

* SYSTEMIC MEDICAL MICROBIOLOGY AND IINFECTIOUS DISEASE : Building upon the principles learned in General Medical Microbiology and Infectious Disease (BMS 6301), the medical student studies in detail infectious diseases in organ systems. The biological characteristics and pathologic mechanisms of infectious bacteria, viruses, fungi and parasites are covered. Functional and clinical implications are presented in the form of relevant clinical case examples that include the use of laboratory testing for diagnosis and treatment.

* SYSTEMIC PHYSIOLOGY : The course serves several important purposes: 1) to review and emphasize key physiological principles from Organ Physiology (BMS 6511; 1st year physiology course), 2) to introduce advanced, clinically relevant physiological concepts, and 3) to integrate selected physiological principles at the organ systems level with information from pharmacology and pathology.
Systemic physiology is a 2 credit hour course that consists of 18 hours of lecture/large group sessions and 12 hours of small group/case sessions. The lectures/large group sessions are designed to illustrate the selected key concepts and allow time for questions and discussion. Small group sessions will consist of a number of clinical cases. Specific objectives will accompany each lecture/large group session handout.

* MEDICINE AND BEHAVIOR II : Medicine and Behavior II addresses the psychological and social basis of patient and physician behavior and the interrelationship between these factors and health, illness and the practice of medicine. The emphasis of the course is on the application of behavioral principles introduced in Human Behavior I to major health concerns (e.g., obesity, substance abuse, and unhealthy life styles), chronic illnesses (e.g., diabetes, hypertension, arthritis, chronic pain syndromes), and psychiatric disorders (e.g., anxiety, depression, psychotic disorder). In addition, ethical dilemmas and challenges in treating patients for the conditions listed above will be discussed. Finally, topics related to medical informatics and evidenced based medicine will be included as appropriate in addressing patient care topics covered in this course.

* HEALTH ISSUES IN MEDICINE : This course provides instruction in health policy, clinical epidemiology, biostatistics, preventative medicine, and strategies for analyzing and improving the public’s health. The critical appraisal of recent medical literature is emphasized.

YEAR 3 COURSES :

* FAMILY MEDICINE CLERKSHIP : The Family Medicine Clerkship is a six-week, community-based, clerkship. Students will spend at least 8 patient care sessions each week observing and providing care for patients under the direct supervision of a practicing family physician. These community-based family physicians are called “clerkship faculty” and are members of the College of Medicine’s clinical faculty.
The educational goals of the Family Medicine Clerkship include:
1. To familiarize each student with the principles and content that define the discipline of family medicine;
2. To provide opportunities for each student to apply these principles and content knowledge in a supervised family practice clinical experience; and,
3. To expose each student to an experienced and competent family physician role model.
The educational content of the Family Medicine Clerkship emphasizes the evaluation and treatment of ambulatory patients with common clinical problems/conditions. Inclusion of other educational content enriches the entire clerkship experience, but the core of the educational experience must focus on improving the student’s ability to recognize, evaluate and manage these common clinical problems/conditions in ambulatory patients.
In addition to the supervised clinical experience, students will document and analyze their clinical experience using the CDCS system, will complete two (2) required clerkship projects and will employ self-directed and faculty-directed learning activities to achieve clerkship objectives.

* SURGERY CLERKSHIP : Surgery is an eight week experience in becoming familiar with the role of surgery and surgeons in the care of patients suffering from conditions that are amenable to treatment by the use of the hand (surgery; fr. Greek: cheir [hand] and ergon [work], literally `handiwork`). Major emphasis in this rotation will be placed upon issues and problems in general surgery, but student familiarity with common textbook problems in the surgical subspecialties (thoracic and cardiovascular, orthopedics, urology, ENT,and neurosurgery) will be tested on the end-of-service examination.
Students will be assigned to a single clerkship faculty member who will shepherd the student experience in the operating room, out-patient clinics, and office based practice. In addition, students will take night call two times per week. For the final two weeks of the rotation, the student will undergo a concentrated subspecialty experience to be chosen by the student, working with the Campus Dean, from among the surgical subspecialties of orthopedics, urology, or otolaryngology.

* PEDIATRICS CLERKSHIP : You will be working with a carefully selected pediatrician in his or her office, and will spend four days per week with this individual. The physician will orient you on the first day to the office practice, and introduce you to the other staff members. You are expected to make hospital rounds with him/her, care for infants in the normal newborn nursery, and see patients in the office daily. You should do one workup per day on a patient that you have no information on, and should see at least five or six patients per day for which you have been given the previous history and medical problems. You will see and examine the patient, and report your findings to your attending physician. At the end of the day, you should sit down with your attending, and discuss some of the patients that you have seen. On one afternoon per week, the clerkship director of your campus will meet with you to talk about some of your experiences and to discuss the computer Med Cases that have been assigned. Please remember to record electronically all of your patient encounters and procedures so that we can assure that you receive the needed experiences. You will find in the syllabus a sample Ambulatory History Form and a sample Newborn Nursery Write-Up. You will also find the current recommendations from the AAP regarding Immunizations.

* IINTERNAL MEDICINE CLERKSHIP : The third year Internal Medicine Clerkship is an eight-week clinical rotation. The objective of the clerkship is to acquaint the student with the varied aspects of medical care for adults. Emphasis will be placed on enhancing the skills of taking a history, performing a physical examination and developing a differential diagnosis for common clinical presentations and problems. Students will participate in the evaluation and care of outpatients and inpatients under the supervision of the COM clerkship faculty physicians. Exposure to common procedures encountered in the practice of Internal Medicine will also be expected. Formal and informal daily teaching sessions and rounds with the clerkship faculty physician (and residents at some sites) are a major part of the eight-week experience. Clerkship directors at the regional campuses will meet with students once per week for teaching, evaluation and feedback. Each student will record and present appropriate clinical data daily to their clerkship faculty member and will be observed performing a complete history and physical examination on at least two occasions during the clerkship by the clerkship director during the rotation. The clerkship will be delivered at each campus with the intent that all students will be able to meet the objectives, regardless of the setting of care. The ratio will be dependent upon the practice patterns of the clerkship faculty at each campus. However, the objectives will remain the same. The Doctoring 3 course, which runs concurrently with clerkships throughout the entire third year will place the student with a community-based longitudinal faculty member for one half-day every week and in the didactic sessions at the regional campus for one half-day every week.

* COMMUNITY MEDICINE CLERKSHIP : The Third Year Community Medicine Clerkship is required for all students at the college of medicine regional campus sites in Tallahassee, Pensacola, Sarasota, and Orlando. This is a three-week clerkship given once in the third year, which is designed to broaden students’ understanding of the role played by community agencies in health promotion and disease prevention. It allows the student to work as a member of a team to assist the agency in fulfilling its goals of maintaining the health of the community. This clerkship also provides students an opportunity to share and discuss their observations with agency members, faculty, and other students. Each student is assigned to a community agency, with a contact person within that agency assigned the role of clerkship coordinator. The Regional Campus Dean will have visited the site and determined its appropriateness for achieving course goals and objectives, and the Dean is responsible for assessing the experiences provided at each site. The Campus Dean will make yearly visits to each agency during the year to assure quality and appropriateness of the experience. In the assigned community setting the student will be supervised by a clerkship coordinator, who will have been oriented by the Regional Campus Dean concerning the goals, objectives and evaluation of the rotation prior to the beginning of the clerkship. Additional student teaching and supervision will be given by the Regional Campus Deans. Michael J Muszynski, MD, FAAP, Orlando Regional Campus Dean, is the current Course Director, who is responsible for course development and course oversight.

* PSYCHIATRY CLERKSHIP : The Psychiatry Clerkship is a six week clinical course that provides third year students with a solid foundation in the fundamentals of the evaluation, diagnosis, treatment, and appropriate referral of patients with mental health disorders. All major psychiatric diagnostic categories will be addressed including: affective disorders, anxiety disorders, psychotic disorders, alcohol and substance abuse disorders, geriatrics disorders, child and adolescent disorders, somatization disorders and personality disorders. (Though the focus is primarily on adults, there will be exposure to the care of adolescents and children when possible.) When appropriate, basic science correlations are also addressed.
The Psychiatry Clerkship will primarily be an outpatient learning experience. The student will be assigned to a preceptor with whom he or she will work the majority of the time. Inpatient psychiatric treatment programs, emergency departments, consultation/liaison services, residential treatment programs, correctional facilities and a host of other community based programs where psychiatry is practiced offer supplementary learning experiences on the four campuses. In addition to treating patients in the outpatient setting, the student’s remaining time will be scheduled as an educational experience in these areas.
In the outpatient setting, students will be provided opportunities to both observe and to participate directly in patient care under the supervision of the clerkship faculty psychiatrist. Students will also follow patients in the hospital setting to gain an appreciation for the range of severity of psychiatric illnesses and the variety of treatment options that are available to those with severe illness. Consultations done in a general hospital provide exposure to the treatment of co-existing psychiatric and medical illnesses. Learning the skills needed for interventions and treatments done in the most acutely ill patients will be achieved from time spent in emergency rooms and other urgent care areas.
Patients of all ages, from diverse backgrounds and multiple ethnicities seen more than half of the time in an outpatient/ambulatory setting is the standard setup of the psychiatry clerkship. It is the fundamental contribution of the psychiatric clerkship to all of medicine to teach students effective interviewing skills and for them to become competent in the diagnosis and treatment of common psychiatric illnesses as they present singularly or as a co-morbid condition to a medical/surgical disease.
The core psychiatry curriculum will be delivered through an Internet based self-study format. A schedule of required readings that address essential topics will be provided. In addition, Clerkship Directors at each regional campus will meet with students a minimum of once every two weeks for case presentations, discussion of required readings and to provide feedback on student performance. The Clerkship Director at each campus will review the Clinical Data Collection System (CDCS) encounters weekly to ensure that students are meeting the psychiatry clerkship objective for the minimum number and variety of diagnoses needed to be seen. It is very important that students record patient encounters and sync their PDA with the CDCS at least twice a week so that this data will be available and current.
As described elsewhere in this syllabus, the criteria for determining the final grade is based on clinical performance as assessed by the clerkship faculty member and the score obtained on the National Board of Medical Examiners shelf examination in psychiatry. The best way to prepare for this examination is to complete all of the required readings and exercises devised by the Psychiatry Education Director and done in consultation with the regional campus Clerkship Directors.

* OBSTETRICS AND GYNECOLOGY CLERKSHIP : Obstetrics and Gynecology is a six-week clinical clerkship. The goal of the clerkship is to acquaint the student with the varied aspects of medical care for women, with emphasis on acquiring the basic skills of gynecologic and obstetrical history taking and physical examination, participating and assuming responsibility in the evaluation and care of outpatients and inpatients, and acquiring practical experience in the operating and delivery room areas with close supervision by staff. Formal and informal daily teaching sessions and rounds with the clerkship faculty and residents are a part of the six-week experience. Clerkship directors at the regional campuses meet with students once per week for teaching, evaluation and feedback. Each student presents a case to the clerkship director each week. These sessions are constructed so as to cover the Association of Professors of Gynecology and Obstetrics objectives under the guidance of clerkship faculty. The criteria used in determining the final grade are the performance evaluations and the National Board Subject shelf examination.

YEAR 4 COURSES :

* ADVANCED FAMILY MEDICINE : The goal of the Advanced Family Medicine Clerkship (“the Clerkship”) is to expose students to the broad scope of practice possible in family medicine. Consistent with the FSU COM mission that emphasizes training physicians to care for patients in rural areas and patients who are medically underserved, the Clerkship takes place in settings that expose students to these patient populations.
Students care for patients under the direction of clerkship faculty, family medicine residency faculty and/or family medicine residents in both the ambulatory and inpatient settings. The Clerkship emphasizes the active participation by students in the evaluation and management of patients with common patient problems/conditions. Students also have opportunities to improve basic clinical skills and learn new procedures/examination techniques. Students document their clinical experience using the CDCS system.

* ADVANCED IINTERNAL MEDICINE: The Advanced Internal Medicine Clerkship is designed to allow students the opportunity to participate in the management of patients with common clinical presentations encountered in the practice of hospital based internal medicine. Each student will have the opportunity to experience a broad range of illness severity ranging from acute care upon presentation to the emergency department to life threatening processes in the intensive care unit. Students will also have the opportunity to improve their basic clinical skills, learn new inpatient procedures and examination techniques, and assess the effectiveness of their clinical interventions.

* CLERKSHIP IN EMERGENCY MEDICINE :One of the principal goals of this clerkship is to introduce students to the role that Emergency Medicine plays in the management of acute disease. The Emergency Department provides an opportunity for significant clinical exposure and learning of many skills. Such skills include appropriately directed patient history and physical exams, differential diagnoses, medical decision making, and acquisition of procedural skills. In the ED, there will be exposure to a broad base of undifferentiated patients with a wide variety of personal, social, and cultural issues that influence patient care. This environment places a premium on physical exam skills and diagnostic reasoning, emphasizing the ability to recognize life-threatening situations and initiate resuscitation in a wide range of diseases with varying degrees of urgency. Students will also be taught to appreciate the dynamic state of emergency medicine knowledge, the necessity for maintaining currency, and the means to do it.

* PRIMARY CARE GERIATRICS : The major goal of this four week clerkship is to provide an in-depth exposure of the medical student to the intricacies, subtleties, barriers and obstacles to be overcome in providing quality primary care to older patients in settings in which it occurs. Under the direct supervision of selected geriatric practitioners, the student on this rotation has the opportunity to participate in the care of older patients in ambulatory, acute inpatient, emergency room, nursing facility, rehabilitation center and assisted living facility sites. An important component of this clerkship is that the student is assigned to follow at least 2 patients through stages of acute, restorative, rehabilitative, institutional, in home or community long term care. Expected student involvement in patient care includes taking histories, performing physical examinations, reviewing patient hospital records and complete medication histories, communicating with families, completing admission and discharge assessments and plans, and participating in patient focused team meetings. The student will perform as a member of the team, providing care for older adult patients with geriatric syndromes and common geriatric problems. Patients who are anticipated to transfer or transition across care settings over the course of the student’s clerkship are selected for student assignment. The student, then, “follows” the patient by maintaining continuity of their participation in the care of that patient for as long as there are active learning issues and the patient is accessible in their new care setting.
There are multiple opportunities for the student to: improve their competency and comfort in caring for older patients in community settings; participate in multi- and interdisciplinary teams; hone their basic geriatric clinical skills; learn new examination techniques; utilize information technology at the point of care and perform functional and other geriatric assessments. Students will gain familiarity with the roles and responsibilities of other disciplines integral to comprehensive geriatric care and become familiar with the skills and attitudes required to function as a team member. The participating clinical facilities are located within reasonable driving distance of the regional campus. The student has opportunities to interact with several physicians and other health professionals involved in the care of each older patient in each of the formal care and community care settings. Three DxR online clinical decision making cases supplement the students active learning by allowing the student to work through cases including collection of history, physical, laboratory and diagnostic procedural data, formulation and justification of hypotheses and development of management plans. The student also is required to complete a PowerPoint presentation on a geriatric topic of his/her own choosing. The Clerkship Director coordinates assignments and monitors student activity with direction and assistance by clerkship faculty, local staff, and the system-wide Academic Coordinator and Education Director.

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