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Clerkship Guidelines
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Family Medicine Clerkship
Guidelines for Students
St. Anthony Family Medicine Residency
- Introduction – we are honored you have chosen to spend time with us. We love teaching medical students and invite you to make the most of your time with us. If you need anything please let the residents, faculty, or staff know and we will do our best to help you. If you have special needs or interests please tell us so we can help this clerkship be fulfilling for you.
- Meals – you will receive meal tickets you can use to purchase food at the hospital cafeteria. Many breakfasts and lunches are sponsored by drug reps in the residency.
- Pager – ask one of the secretaries or program coordinator to obtain a pager.
- Parking – parking is free in the parking garage adjacent to the professional building on 9 th street.
- Ambulatory clinics (FMC, Saints Physicians North, and Mustang Complete Care)
- The hours of operation are from 8:00 AM – 4:30 PM.
- Experiences include routine continuity clinics with a resident or faculty and procedure clinics (FMC) including dermatology and colposcopy clinics.
- Expectations:
- Arrive at 8:00 AM.
- You aren’t expected to see each patient. Ideally, you and your preceptor should review the schedule to pick 3-4 patients for you to see individually. You should write a progress note and present to the preceptor. Presentations should include pertinent history, exam findings, and your assessments and plans. Your progress notes do not become a part of the chart, but may be useful to your supervising physician. Please bring several of your notes to your rotation supervisor (Dr. Wright or Dr. Abell) for critique.
- Feel free to pick patients with interesting findings.
- For afternoon clinics, you should expect to be finished at 4:30.
- Locations
- Family Medicine Center – downtown/residency site
- Saints Physicians North (SPN) – St. Anthony North - Broadway Extension and 63 rd . Ph. 272-5555.
- Mustang Complete Care – 501 N. Mustang Road. Ph. 376-0376
- Inpatient Medicine Services (Gold Team/Silver Team)
- Hours
- Check out 7:00 AM and 6:00 PM.
- Teaching rounds begin at 10:00 am in the ICU.
- Expectations
- Externs should carry 2-3 patients.
- Interns and upper level residents will supervise externs.
- Externs should write progress notes, using the SOAP format, and leave in the chart. Remember to write your supervising physician’s name after your signature.
- You may write orders, but you must have them countersigned by a licensed physician at the time you write the orders.
- Externs should present the patients they have seen on teaching rounds.
- Good presentations are concise (no longer than 3 to 5 minutes) and well-organized, and include relevant history (if new patient include chief complaint, HPI, PMH, Meds, Soc History), relevant exam (include vitals), your assessments, differential diagnoses and plans.
- Tip - Volunteer to research clinical questions that surface on rounds.
- Afternoons
- Help with admissions, discharges, and follow up patient tests and procedures.
- The primary purpose in our interactions with patients is to provide excellent, evidence-based care. Keep in mind that your observations and suggestions can be very important to patient care. Inasmuch as you have more time to get to know your patients and study their conditions, you might be able to provide the missing piece of the puzzle, or otherwise make significant contributions to their care.
- Suggested reading – obviously this is a broad list. Some possibilities include: fluids and electrolytes; acid/base disorders; pneumonia; COPD exacerbations; pulmonary embolus and DVT; acute coronary syndromes and CHF; GI bleeding; stroke; delirium; dementia; DKA; hyperosmolar syndromes; sepsis; urinary tract infections; alcohol withdrawal syndromes; DVT prophylaxis.
- Resources: Washington Manual, Ferri’s Guide to Care of the Medical Patient, Up to Date (available on SAH computers free of charge) Visit our medical librarian for an introduction to the medical library.
- Labor and Delivery
- Check-out 7:00 AM and 6:00 PM
- Who makes up the family medicine obstetrics team?
- Family medicine resident, faculty, medical students
- Patients family medicine residents are responsible for:
- SAH patients
- FMC OB patients
- Faculty OB patients
- Dr. Bhoplay patients
- Dr. Martin patients
- Expectations
- Laboring patients – typically, cervical exams every 2 hours during latent phase, and every hour during active phase. Go with the resident and have the resident check behind you to assess your accuracy.
- Post-Partum notes by rounds (typically around 8:00 AM)
- Labor Progress note example (get a copy of the resident’s Pocket Handbook for more details)
S: comfortable with epidural.
O: SVE 5cm/ 100% effaced/-1 station
FHT 130s, reassuring
Pitocin @ 10 mU
A: Term pregnancy
Active labor
P: Continue with pitocin augmentation
S: Some uterine cramping. Minimal lochia.
Voiding and ambulating okay. No perineal
pain.
O: BP 120/80 Temp 98
Chest: CTA HRRR
ABD: fundus firm at umbilicus
Labs: H/H 10/30
A: PPD # 1 SVD
P: D/C home
- Other responsibilities
- Outpatient evaluations
- evaluations for labor, ruptured membranes, non-stress testing
- Ultrasound clinic – occurs weekly in the FMC. Ask resident when it is scheduled.
- Other suggestions
- Ask if you can carry OB pager when resident/intern is in clinic.
- Reading (ask to see our notebook with OB readings)
- routine pregnancy
- pre-natal care
- management of the laboring patient
- cervical ripening
- indications for induction of labor
- management of group B strep colonization
- hypertension in pregnancy
- fetal monitoring
- first trimester bleeding
- third trimester bleeding
- shoulder dystocia
- labor dystocia
- post-partum hemorrhage
- Didactic Experiences – students welcome
- Morbidity and Mortality Conference – monthly
- Grand Rounds – weekly
- Procedure Conferences – monthly
- Journal Club – monthly
- MedChallenger – this is our resident’s weekly reading program available over the internet. Access requires a license. If you’d like to see some of the modules let us know and we will show you some of the modules via the faculty accounts.
- Other activities
- Bible Study, Community Prayer, Faith Sharing, Missions Fellowship – announced periodically – students welcome
- Chief’s meeting – this is for residents only
- Resident and Faculty Meeting – for residents and faculty only
- Balint Group – residents only
- Feedback – let us know how your rotation is going midway through your time with us. We will do likewise. If there are areas that intrigue you and you would like more exposure, let us know. Once again, we want this to be an exceptional experience for you so that you will know the joy of family medicine.
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