Syllabus for Introduction to Underserved Medicine Selective

Introduction to Underserved Medicine Selective

Syllabus for Introduction to Underserved Medicine Selective

General Course Information

Course: FPM 410 Introduction to Underserved Medicine Selective

Course Directors: Dr. Sunny Smith and Dr. Michelle Johnson

Administrative Contact: Lisa Deferville

The purpose of this 3rd year selective is to immerse the student in the principles and practice of underserved medicine in an urban setting, and to teach core knowledge, attitudes and skills in the effective practice of family medicine in underserved communities. The student will be involved in clinical experiences at the UCSD Student-Run Free Clinic Project, community health centers, school-based clinics, and will also have didactic and reflection sessions on primary care topics (i.e. diabetes and hypertension) and underserved medicine topics (i.e. health care disparities, and social determinants of health).

Participating Instructors:

Faculty: Dr Michelle Johnson, Dr Sunny Smith, Dr. Natalie Rodriguez, Dr. Kristin Brownell, Dr. Raul Trejo, Dr. Brendan Kidder, Dr. Mary Richards, Dr. Pomai Roberts, Dr. Katie White, Dr. James Cevallos, Dr. Christina Dies, Dr. Karla Garcia, Dr. Mary Palomino, Dr. Setareh Jones.

Clinic locationsvary and relevant addresses can be found on your individual schedule

Schedule: Monday through Friday, no more than 40 hours per week with a combination of day and evening clinics. No weekend activities or overnight call.

Course Goals and Learning Objectives

The learning objectives for this course include the following:

By the end of the selective students will be able to:

Demonstrate core history-taking skills, physical exam skills, oral presentations, and written documentation.
Formulate differential diagnosis for common primary care concerns
Describe common issues in the management of patient who have chronic illnesses such as diabetes, high blood pressure, and asthma
Define what is meant by “underserved” communities
Define what is meant by “social determinants of health” (SDH) and describe how this relates to medically underserved communities.
Identify barriers to health and well-being in underserved populations, such as access to healthcare, limited transportation, low health literacy
Demonstrate knowledge of existing health disparities

Course Requirements

1)Attendance at all clinical and didactic sessions: attendance record must be turned in at the end of the selective (see absence policy below).

2)Review the required reading (see reading list at the end of the syllabus)

3)At least one history and physical examination observed by course director

4)Final case presentation to course director(s)

5)Complete Course Evaluation

Absence Policy: Students are not permitted to miss any days of this rotation except in special circumstances such as personal or family emergencies. To request an absence due to unforeseen circumstances, the student must notify Lisa Deferville as soon as possible. ( or 858-534-6160). All missed days must be made up in order to receive a passing grade.

Required Reading:In order to be an effective primary care clinician, it is important to understand that a large part of how we practice is based on guidelines provided by national organizations that are revised over the course of time as more data becomes available. These guidelines are always being revised. Please read the guidelines listed at the end of the syllabus that are applicable to primary care. One of the items on the reading list is a journal article that summarizes the UCSD Student-Run Free Clinic Project. The last items on the reading list are relevant to the understanding of core topics in underserved healthcare such as social determinants of health and health disparities.

Observed History and Physical Examination: Each student will have at least one history and physical exam observed by one of the course directors and direct feedback will be given.

Final Case Presentation: Each student will prepare a case presentation for the final day of the rotation. The case should be based on an actual patient seen by the student during the selective. The case presentation should demonstrate clinical knowledge and awareness of at least one issue related to underserved medicine (i.e. limited access to care, low health literacy, effect of poverty on health, etc).

Course Evaluations: Medical students must complete course and faculty evaluations of this and all school of Medicine courses in order to receive a grade. The identity of individual students will not be shared with course instructors.

Student Assessment/Grading

This selective is pass/fail. A passing grade is achieved when the course requirements (listed above) are met.

The course directors will complete evaluations online in OASIS through the Office of Educational Development and Education (OEDE), which is used to grade students’ performance. Other supervising physicians may additionally complete this evaluation.

Students are assessed on:

Ability to obtain a complete history and physical exam, verbal presentation skills, note writing, and ability to form an accurate assessment and plan. Their clinical skill set and knowledge base is judged based on repeated interaction with core continuity faculty members.
Ability to interact well with patients, their families, and other members of the health care team.
Knowledge and comments during didactic sessions with the course directors and faculty throughout the clerkship are also used in assessing the students.
Final case presentation which should demonstrate clinical knowledge as well as awareness of issues related to underserved medicine.
Criteria for a Passing Grade:
Attendance of required clinical sessions
Participation in clinical care
Satisfactory oral presentations and written notes
Completion of at least one observed History and Physical Exam
Attendance at required lectures/didactics
Final case presentation
Satisfactory performance/demonstration of learning objectives
Note: there is no final written examination for this course

For unethical or unprofessional discretions that could result in "failure," please see the Policy on the Evaluation of Professionalism in the Advisor and Student Handbook

Recommended Reading List:

1. Cholesterol Treatment Guidelines:

-2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. (Stone NJ et al. Circulation. 2013 Nov 12.)

2. Hypertension Treatment Guidelines

-JNC 7: Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. (JAMA. 2003;289:2560-2572.)

-JNC 8: 2014 Evidence-Based Guideline for the Management of High Blood Pressure in AdultsReport From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) (JAMA.2014;311(5):507-520.)

3. American Diabetes Association Standards of Medical Care in Diabetes 2016.

Standards of Medical Care in Diabetes 2016 available at

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-centered Approach. Available at

4. Asthma Guidelines

The Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma — Full Report, 2007. Available at:

5.Overview of the UCSD Student-Run Free Clinic Project

"The UCSD Student-Run Free Clinic Project: Transdisciplinary Health Professional Education". Journal of Health Care for the Poor and Underserved. Volume 16: Number 2. May 2005: 207–219.

6. Underserved Medicine Topic: Social Determinants of Health

“Closing the gap in a generation: Health equity through action on the social determinants of health” Executive summary available at:

7. Underserved Medicine Topic: Health Disparities

National Healthcare Disparities Report, 2014, developed by the Agency for Healthcare Research and Quality (AHRQ). Available at:

8. Depression screening and management at the UCSD Student-Run Free Clinic Project

Revised 3.30.2016