This rotation involves spending 4 weeks embedded within a primary care or sub-specialty ambulatory setting throughout our academic health system and the communities it serves. Students will grow their history, physical, assessment and plan skills for the types of patients receiving care at their particular site. Through this experiential learning opportunity, students will be challenged to understand their patients as persons navigating complex health systems about their unique circumstances and life stories. In addition, students will be challenged to apply health systems quality improvement principles and think about ways to harness technology and quality improvement principles to the ambulatory setting. The student schedule will be focused on one particular clinical site with one primary preceptor. Students will have 2-3 half days with no assigned clinical duties during which they are expected to complete the assessments outlined below.
Prerequisite: Completion of Phase I.
This rotation involves spending one week with the Division of Geriatrics faculty caring for patients in post-acute care and skilled nursing facilities providing primary care for medically complex older adults, and performing dementia care consultations in the outpatient memory clinic. This week will focus on learning how to perform: a) appropriate geriatric patient assessments, including but not limited to mental status examinations, capacity assessments, frailty assessments, assisting with end-of-life decision making (including surrogate decision making and futility assessments), b) functional assessments, and c) building knowledge about healthy aging processes. It will also include reflection on the benefits/challenges with coordination of care across care settings and how to collaborate with interdisciplinary team members to maximize independence and deliver optimal, safe, age-friendly care. Another week is spent embedded in the Cancer Institute experiencing patient care delivered at the infusion center, the interdisciplinary CARE Center, and the oncology clinics. Through these experiences, students will not only learn about healthy aging versus aging with medical complexity, but they will also gain insight into key systems science and humanities principles such as coordination of care, interdisciplinary teaming, ethics at the end of life (including advance care planning, futility assessments, capacity assessments, and surrogate decision making), and the challenges of current health system structures and processes. Students will work directly with multiple different team members, including psychologists, advanced practice providers, and physicians to learn how multidisciplinary institutes deliver multifaceted, optimal patient care in one setting. Students will also attend tumor boards and grand rounds at the Cancer Institute which are ideal settings to learn essential coordination of care and clinical reasoning skills. Through experiences in both contexts, students will be challenged to understand their patients as persons navigating complex health systems in relation to their own unique circumstances and life stories. In order to closely approximate the schedule students will have when they become attending physicians, the schedule is comprised of half days of experiences. Students will have 2-3 half days with no assigned clinical duties during which they are expected to complete the assessments outlined below.
This four-week long course is an elective available to students enrolled in Phase III. The aim of this course is to 1) establish a service learning elective rotation for medical students to be embedded in a community organization, 2) have students actively apply their knowledge and skills in the Quintuple Aim (i.e., health equity, provider satisfaction, patient satisfaction, population health, lowering costs) by engaging in a continuous quality improvement project identified by the community organization, and 3) teach students the practicalities and barriers to identifying and addressing health inequities so they learn how to advocate for change.
This course revisits key systems science and humanities concepts in the context of clerkships, while also preparing students for the UME to GME transition. Students will engage in Morbidity and Mortality (M&M) conferences and analyze each M&M case from a systems and humanities lens. Students will also practice advanced clinical skills that require excellence in humanities and systems domains, such as how to perform quality improvement projects, effectively transition care of a patient to a night team or separate team entirely, place orders and call consults, organize a team in urgent care situations, and how to engage in an informed consent dialogue. In addition, the course includes key professional development topics such as instruction on 1) building a personal statement for residency applications, 2) the process of selecting residency programs to which to apply, and 3) approaches to residency interview season.