Generalgoals and Objectives for Rvucom Clinical Rotations

GENERALGOALS AND OBJECTIVES FOR RVUCOM CLINICAL ROTATIONS

THIRD YEAR CLASS

Main Education Goal: Observation of clinical services and procedures,and history and physical gathering

The main objective of the third year in medical school is to provide clinical observation experiences in the core specialties of medicine and surgery. These core fields are Family Medicine, Internal Medicine, Obstetrics/ Gynecology, Surgery (both general and specialty), Pediatrics, Geriatrics, and Psychiatry. The major activity is to primarily observe and participate in health care activities as directed by the chief of the service. Third year students have passed their national board on the basic sciences of medicine and have had labs and instruction on common diagnostic procedures such as blood work, UAs , spinal taps, joint aspirations, EKG interpretation, and radiology reading including CT and MRI. Students are trained in ACLS and BLS procedures.

Third year students are most skilled in history taking and physical exam skills and are expected to function in this capacity at the beginning of the rotation. Third year students will come with knowledge of surgery scrub techniques and basic OB delivery skills. They understand they are to mostly observe procedures and participate in any activity the attending physician requests them to do.

DIDACTIC ACTIVITIES

Student will be expected to participate in any didactic programs that occur in the hospital or residency program. Rocky Vista University will have self study and point of care learning activities that will supplement the clinical experience. At the end of each clinical experience, the students will be given a Shelf Exam that they must pass to complete the rotation. The medical school will be responsible for providing the Osteopathic Skills education to the students. A complete outline of these activities will be available to the clinical rotation sites.

Rocky Vista University is mindful of the fact that it is impossible to write a curriculum for clinical rotations, because the experiences are dependent on the patient mix and demographics. We therefore have formulated general guidelines and objectives that may, or may not, be achieved during the clinical experiences.Many times it is helpful to look at the six top diagnosis codes for that service and design the program around that. The following is a listing by core subjects of the suggested goals for that service.

INTERNAL MEDICINE

Major Goal: To observe and participate in the workup and management of Internal Medicine patients both inpatient and outpatient.

• Admission History and Physical taking;
• Observation of Treatment Plan formulation and Order writing;
• Observation of the management of common internal medicine problems.

FAMILY MEDICINE

Major Goal: To observe and participate in the inpatient and outpatient activities of the Family Practice Service.

• Outpatient management of Hypertension;
• Outpatient management of Diabetes;
• Preventive Health Education;
• Out patient Management of Common Respiratory Problems;
• Prenatal care if provided in the FP Clinics;
• Management of Depression.

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PEDIATRICS

Major Goal: To observe and participate in the work up and management of inpatient and outpatient pediatric patients.

• Management of common childhood illness;
• Immunization evaluation;
• Management of common Infectious disease problems in children; Well Child checks;
• Well checks
• Pediatric Nutritional counseling;
• Observation of inpatient procedures if applicable.

OBSTETRICS AND GYNECOLOGY

Major Goal: To observe the management of the Obstetrical Patient in pre- partum, intra-partum, and post-partum periods, and observe and participate in the work up and management of common OB/GYNProblems.

• Observe the initial OB Exam Process;
• Observe the Prenatal visits and various stages of gestation;
• Observe OB Ultrasonography;
• Observe a normal delivery;
• Observe and understand Fetal Monitoring;
• Observe Operative Deliveries, as applicable;
• Take night call with attending, if applicable.

SURGERY

Major Goal: To observe the work up and treatment of surgical patients both general and specialty types.Observe the treatment of the patient in the intra-operative period.

• Perform Pre-Op Histories and Physicals for surgical patients;
• Observe and participate in the surgical decision making process;
• Participate in pre-operative and post-operative care of the patient;

• Become familiar with the roles of the various surgical specialties in the treatment of the patient;
• Observe and scrub, if applicable, on surgical cases selected by the surgeons;
• Observe the treatment of the patient in the intra-operative period.

PSYCHIATRY

Major Goal: To observe the work up and management of the patient with Mental Health/Behavior Disorders both in the acute and chronic setting.

• Observe and become proficient in using the mini mental status exam;
• Observe the evaluation of acute mental health problems;

• Observe the decision making process for the treatment of patient with behavioral disorders;
• Observe the workup and treatment of patients with substance abuse problems.

THIRD YEAR SELECTIVES

Third year selectives include Anesthesia, Emergency Medicine, Neurology, Radiology, Medical and Pediatric Subspecialty, and Subspecialty Surgery.

The student is mainly expected to observe and assist upon direction of the attending or supervising physicians. The students will have had extensive training on hospital policy and procedure as well as completed ACLS and BLS and can function in areas the physicians and staff feel appropriate.

They have had formal procedural training in outpatient diagnostic procedures including minor office surgery and spinal taps. They have also received basic instruction in wound care and suturing.

The students can function as part of the team by collecting data from performing histories and physicals as well as organizing lab data that has been collected from the patient. The students have also had extensive training in formal presentation of clinical material and are expected to observe the formulation of treatment plans. They are expected to be on call with physicians if deemed appropriate by the clinical service.

FOURTH YEAR ROTATION OBJECTIVES

The purpose of the fourth year of medical school is to prepare the student to enter the residency program of their choice. This year has fewer core requirements and more elective rotations which are the student’s choice. During the first half of the year it is to the student’s advantage to seek a rotation at the facility that they would want to match with after graduation.

Core subjects that offer greater autonomy and require more experience are done during the fourth year.These courses are Critical Care Medicine for one month, Emergency Medicine for one month, and Rural Family Medicine/Indigent care for two months. The remaining seven months are selectives.

The fourth year selectives are Sub-Internships where students can participate in procedures such as vaginal deliveries, culposcopy, endoscopy, minor surgical procedures, exercise stress testing, and formulating treatment plans. The fourth year student can also help teach third year students on the rotations. The length of these experiences depends on the choice of the student in conjunction with the training institution.

CRITICAL CARE MONTH

Major Goal for Critical Care: To participate as part of the team in a large urban critical care unit.

EMERGENCY ROOM

Major Goal for Emergency Room: To function as part of the ER Team and participate in the work-up as well as treatment of patients. The student also will be expected to assimilate patient data and participate in the formation and delivery of treatment plans to be approved by a physician. A fourth year student should have the skills to deliver many of the basic emergency room procedures under direction and supervision of attending staff and physicians.

SELECTIVE ROTATIONS AND SUB-INTERNSHIPS

Major Goal: To provide students with the opportunity to set up rotations at sites that they may wish to enter residencies. Students who have decided on a field of specialty could use this opportunity to focus on pre-residency training in a sub-internship.