DEPARTMENT OF FAMILY & SOCIAL MEDICINE

• Enhance their level of competence in prevention, diagnosis and treatment of common ambulatory problems
• Integrate bio-psychosocial approaches in their care of patients and families
• Explore aspects of culturally-responsive care, the Patient-centered Medical Home, community-oriented primary care, and social medicine.

LEARNING EXPERIENCE:

Students will be directly involved in the evaluation and treatment of ambulatory patients in patient care sites affiliated with Montefiore Medical Center, including the DSFM Family Medicine residency program.  The student will gain broad medical experiences serving diverse urban communities.  Students will work under the supervision of Family Medicine faculty, and will be expected to independently evaluate patients and formulate treatment and follow-up plans for review with their preceptors.  Students will attend all educational conferences, tour community agencies of the Bronx, and will have opportunities to attend inpatient rounds of the Family Medicine service, participate in palliative care home visits and precept cases with behavioral sciences faculty.

LOCATION:  Family health Center and Williamsbridge Clinics of Montefiore, home visits with Metropolitan Jewish Home Care, and various other community partner settings.

COURSE DIRECTORS:  Pablo Joo, M.D., Director of Medical Student Education - DFSM
Main Contact Number: (718) 430-2900
Main Contact Email: pjoo@aecom.yu.edu

Lisa Baron, M.D., Associate Residency Director
lbaron@montefiore.org

Andrea Ritchin, M.D., Medical Student Site Director - Family Health Center
aritchin@montefiore.org

Mark Polisar, M.D., Medical Student Site Director - Williamsbridge Family Medicine
mpolisar@montefiore .org

Given:  All year round except July (effective August 2009)

MAXIMUM:  1 student per month

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  The course directors will compile a final evaluation based upon the evaluations by all preceptors.

FM15 Urban Ambulatory Family Medicine @ Beth Israel Family Medicine Residency Program

DESCRIPTION:

The purpose of this rotation is to provide students with a variety of experiences that comprise Family Medicine in an urban, underserved setting.  clinical experience encompasses inpatient care, outpatient care, women's health, outpatient procedures, complementary and alternative medicine (CAM).

OBJECTIVES:

Students will:

• Gain clinical experience in CAM
• Gain clinical experience in women's health/abortion care
• Gain clinical experience in the homeless care setting
• Demonstrate proficiency in patient care in the outpatient family medicine setting

Describe the differences of delivering primary in its various settings, e.g. community health care center, homeless shelter, women's health setting, CAM.

LEARNING EXPERIENCE:

The students on this rotation will experience clinical care in various settings that Family Practitioners practice, as mentioned before.  The goals of this rotation are to have the interested medical student gain more experience in Family Medicine, as well as gain experience in the various ways it can be practiced.

LOCATION:  The settings for the elective include Beth Israel Medical Center, Manhattan sites of the Institute for Family Health, and homeless sites with Manhattan.  Students are to rotate to Zudith Lopez at 9am on the first day of elective.  All of the preceptors are Family Medicine attendings and senior Family Medicine residents.

COURSE DIRECTOR:   Ray Teets, M.D.
Main Contact Number: (212) 206-5228
Main Contact Email: rteets@institute2000.org

GIVEN: All year round except July and August

MAXIMUM:  2 students per month

FEEDBACK:  Students will receive immediate feedback after procedures and observed counseling and the end of the rotation.

EVALUATION:  Evaluations are given to preceptors who have worked with the medical students two sessions or more, and from these evaluations an average grade is calculated.
 

BEHAVIORAL SCIENCES

FM4 Family, Systems and Health

DESCRIPTION:

This elective will focus on family and systemic factors influencing health and the doctor-patient relationship.  Topics addressed include somatization, chronic and terminal illness in addition to common behavioral health issues presented in primary care.

OBJECTIVES:

• Students will be able to describe typical behavioral and psychosocial approaches to medical problems in primary care;
• Students will be able to examine the role of family and social relationships in health;
• Students will be able to identify common systemic health care related factors which affect the health of patients from disadvantaged backgrounds.

LEARNING EXPERIENCE:

Students will be able to interview patients and observe faculty during patient care sessions.  Individual tutorials, readings and attendance to didactic sessions are also available.  The elective is tailored  to the interests and needs of the student.

LOCATION:  The DFSM office at 3544 Jerome Ave Bronx NY 10463. Clinical sessions will be at the Family Health Center, 360 E 193d Street.

COURSE DIRECTOR:  Eliana Korin, Dipl. Psych.
(718) 920-2821
ekorin@montefiore.org

GIVEN:  Winter and spring seasons

MAXIMUM:  1 student per month

FEEDBACK:  Students receive formal feedback midway and at the end of the rotation.

EVALUATION:  Verbal evaluation plus questionnaire

FM26 Understanding the Spiritual and Religious Dimension of Patients

DESCRIPTION:

This 4 week elective course explores spirituality and religion as it impacts patient's health and care management.  A combination of clinical experiences and classroom seminars are provided to build knowledge, skills and potential change in attitude surrounding the importance of this patient dimension.  Students are encouraged to reflect on their own religious and spiritual selves as it impacts the doctor-patient relationship and sustains the practice of humanistic medicine.

OBJECTIVES:

• Develop a respect for and collaborative relationship with clergy and other spiritual leaders as members of an inter-professional team.
• Understand that spirituality and religion provides a view of life for some patients that gives hope, meaning and a sense of security during health, illness, pain and suffering and at the end of life.
• Learn the communication skills to address spirituality and religion with patients that respect their beliefs and values regarding health and health care management.
• Explore and reflect on one's spiritual and/or religious self as it may impact the doctor-patient relationship and help to sustain the practice of humanistic medicine.

LEARNING EXPERIENCE:

Opportunities include joining a hospital chaplain on patient visits; interviewing patients with chronic illness, terminal illness and pain, and attending conferences/lectures and seminars.  Complementary and alternative practices within the realm of spirituality will be included.  Weekly seminars focus on discussions with core faculty facilitators and invited guests regarding the intersections of patients spirituality with clinical issues, assigned readings and research studies.

LOCATION:  Students need to report to Mimi McEvoy at the medical school, Belfer 507 on the first clinical day.  Other settings: Calvary Hospital for 1 week; Home visits; Acupuncture with Sonia Lopez, MD at her site; In classroom discussions of readings in Belfer

COURSE DIRECTOR:  Mimi McEvoy, NP, MA
(718)430-3167
mcevoy@aecom.yu.edu

GIVEN:  May only

MAXIMUM:  6 students per month

FEEDBACK:  Students are encouraged to reflect on their experiences and reactions in small groups discussions with faculty and peers.

EVALUATION:  Faculty writes comments in response to this essay.  In addition, we write an end of year evaluation for each student using the standard elective evaluation form.  AECOM students who need to fulfill their SP requirements can be mentored in this elective, if they pick a related topic to the elective.
 

 
COMMUNITY AND CULTURAL MEDICINE

FM2 Community-Oriented Primary Care

This elective introduces the student to the model of community-oriented primary care as developed by Dr. Sidney Kark and hi co-workers in Israel and south Africa.  An entire movement of primary care leaders, practitioners, and researchers has adapted this model, integrating primary care and public health.  Students will work at one of our community-based projects such as health care for the homeless team, a mental health program for Southeast Asian immigrants, or a lead poisoning prevention program.  This elective is tailored to the individual student's interest.

Hal Strelnick, M.D.
(718) 920-4678
hstrelni@montefiore.org
All modules

Interested students should contact the instructor before registering for this elective.

FM3C Culture and Care

DESCRIPTION:

This elective will address the complexities of providing medical care to patients from diverse sociocultural backgrounds.  Students will have the opportunity to see patients at a community health clinic to examine medical problems in relation to particular sociocultural determinants.  They will learn about health beliefs and practices among diverse sociocultural groups, immigrant health issues and their impact to the doctor-patient relationship and health care in general.

OBJECTIVES:

• Formulate medical problems within a socio-cultural framework
• Examine typical clinical problems in relation to social determinants of health
• Integrate a socio-cultural perspective into the medical interview
• Describe common challenges faced by immigrants and their impact on health and health care

LEARNING EXPERIENCE:

Interview with patients, and observations of faculty interactions with patients; readings, videotape reviews and tutorials.

LOCATION:  Residency Program in Social Family medicine, Jerome Ave. and the Family Health Center Clinic.

COURSE DIRECTOR:  Eliana Korin, Dipl. Psych.
(718) 920-4678
ekorin@aecom.yu.edu

GIVEN:  all year round except Fall months

MAXIMUM:  1 student per month

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  Teaching faculty contribute to the final evaluation

FM8 The Health and Healthcare Needs of Lesbian / Gay / Bisexual / Transgender Community

DESCRIPTION:

This elective will examine the health and healthcare needs of the lesbian/gay/bisexual/transgender (LGBT) patients through readings, patient encounters and community based experience.  Available areas of study include life cycle, bias, violence, identity, health promotion, prevention and clinical practice.

OBJECTIVES:

At the end of the elective, students will be able to:

• Identify the healthcare needs of lgbt patients
• List the challenges faced by lgbt patients in accessing care
• Identify ways to overcome these challenges
• Identify Bronx resources for lgbt patients

LEARNING EXPERIENCE:

There will be opportunity to work with community based organizations such as the Bronx Community Pride Center (http://bronxpride.org) and clinical experience with providers interested in providing care for this diverse community.

LOCATION:  South Bronx Health Center for children and Families, Peter Meacher MD Bronx Community pride Center, Robert Beil MD & Lisa Winters[Executive Director]

COURSE DIRECTOR:  Dr. Peter Meacher
(718) 991-0605
pmeacher@montefiore.org

Dr. Robert Beil
rbeil@montefiore.org

GIVEN:  All year round

MAXIMUM:  1 student per month

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  combined assessment of all elective leaders.

FM14 Community Assessment, Research & Epidemiology

This course will introduce the student to the place of clinical and social Epidemiology within primary care practice.  Emphasis will be given to questions of community needs, assessments defining community, measures of health status, survey and screening techniques, sociocultural impacts upon health and diseases and basis research design.  Students will develop a research project from data gathered in their own practices.  Critical approaches to methodology and to the medical literature will be developed.  Problems with particular data sources (e.g. birth certificates) will be reviewed.

Hal Strelnick, M.D. and guest speakers
(718) 920-4678
hstrelni@montefiore.org

FM30 Medical Spanish Immersion in the Bronx

DESCRIPTION:

This 5-week elective will provide a Medical Spanish Immersion experience in a family medicine practice in the Bronx.  Students will work with an interdisciplinary team and will conduct interviews and physicals with mono-lingual patients in Spanish. Two mornings a week the students will receive Medical Spanish instruction at the medical school. Intermediate Spanish is required (assessed by instructor). 

 OBJECTIVES:

The student(s) will

• Develop communicative competence to communicate with Spanish-speaking patients particularly in the Bronx community.
• Ask yes/no questions and open questions using different grammar tenses to avoid inaccuracy while conducting the medical interview in Spanish.
• Be familiar with some Spanish terms used by Latino/Hispanic patients.
• Develop a wide variety of medical Spanish terminology through the textbook and Latino/Hispanic patients at the Mount Hope Family Practice.
• Learn about Latino/Hispanic patient's most common cultural and health beliefs.
• Learn about some herbal and home remedies used by the Latino population
• Conduct interviews and review of systems in Spanish.
• Conduct health education for patients in Spanish with clinic team.

 LEARNING EXPERIENCE:

The student will have intensive Spanish language instruction 2 mornings a week for 5 weeks.  At the clinic the student will conduct interviews and physicals in Spanish.  Student is also expected to worth with clinic team (social worker, nurse) regarding Diabetes health education and support.  Students will also be required to attend seminars on Ethno medicinal plant use in the Latino population.

LOCATION:  First day of the elective the student will report to Dr. Marzan and Ms. Yovana Quecano for an orientation and oral assessment of Medical Spanish (Ms. Quecano).  Most of  the clinical experience will be at Mt. Hope Health Center supervised by Dr,  Cortijo.  Two mornings a week, the student will be at the medical school for intensive language instruction, and assessment.

COURSE DIRECTOR:  Dr. Maria A. Marzan 
Asst. Professor Department of Family & Social Medicine
(718) 430-3419
mamarzan@aecom.yu.edu

Dr. Amarilys Cortijo
Medical Director, Mount Hope Family Practice

Ms. Yovana Quecano
Medical Spanish Coordinator
718-430-2406
yquecano@aecom.yu.edu

GIVEN:  April only

Maximum:  2 students

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  There will be 2 components.  Formal evaluation of Medical Spanish assessed by instructor testing, and an evaluation by the attending by observation of clinical and language skills.

COMPLEMENTARY MEDICINE

FM5 Complementary Therapies and Alternative Healing

DESCRIPTION:

This elective will provide the student with an introduction to the philosophy of integrative medicine and a supervised exposure to complementary therapies and alternative healing methods in primary care settings (e.g. community health center and small practice).  Among the therapies to be covered are meditation, relaxation techniques, acupuncture, acupressure, biofeedback, shiatsu massage, chiropractic, energy and herbal medicine.  

OBJECTIVES:

• Examine the philosophies of integrative medicine
• Analyze how these philosophies differ from Western conventional medicine
• Identify areas of complementary and alternative medicine (CAM) to address more deeply
• Explore these areas through reading and observation
• Examine the evidence base for these CAM approaches
• Reflect on the place of CAM approaches for self and future patients
• Describe the integration of CAM approaches in future patient care

LEARNING EXPERIENCE:

Students will read and discuss introductions to integrative medicine philosophies and techniques.  Students will rotate with practitioners of many different healing modalities depending on their interest.  Students will meet with the course director throughout the clerkship to review what they have observed and reflect on its place in their own self-care and the future care of their patients.

LOCATION:  Students will contact me to schedule the first meeting.  The elective places students with practitioners throughout the city depending on their interest.

COURSE DIRECTOR:  Ellen Tattelman, M.D.
(718) 920-4678
etattelm@montefiore.org

GIVEN:  Variable.  Please call ahead.

MAXIMUM:   1 student per month

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  Evaluation is based on the student's motivation and initiative as well as their grasp of similarities and differences among a number of different healing systems and modalities.  Evaluation is also based on the student's depth of reflection on the place of integrative medicine in their future care.

GLOBAL HEALTH

FM29 Elective in Global Health in Guatemala

DESCRIPTION:

There is a limited number of positions available for medical students in Central and South America.  Research opportunities exist at a large HIV clinic in Guatemala City.  Clinical opportunities exist in both rural and urban settings throughout the region.  Interested students should send their CV's and a cover letter to either Dr. Anderson or Dr. Smith before registering.

OBJECTIVES:

• Develop familiarity with clinical management of HIV in a non-HAART setting.
• Understand the social and economic context of HIV in Guatemala.
• Improve Spanish
• Participate in an ongoing research problem.

LEARNING EXPERIENCE:

Students will work in an HIV outpatient and inpatient care under supervision, visit CBO involve in HIV and participate in research.

LOCATION:   Clinica Luis Angel Garcia, Guatemala City, Guatemala

COURSE DIRECTOR:  Dr. Matthew Anderson
(718) 933-2700
andersonma@aol.com      

Dr. Smith
Vae6x6qm@verizon.net

GIVEN:  All year round

MAXIMUM:   1 student per month

FEEDBACK:  Students will receive formal feedback weekly.

EVALUATION:  Verbal reports of supervisors in Guatemala

 
HEALTH CARE SYSTEMS

FM11 Political Economy of Health Care

This elective will provide the student with a research and/or tutorial experience in the study of economic and political dynamics of the American health care system as part of the ongoing research of the faculty.

Hal Strelnick, M.D.
(718) 920-4678
hsterlni@montefiore.org

Students should contact the instructor before registering for this elective.

FM12 Understanding Healing Systems and Health Teams

This course introduces the student to the development of the American Health system and to the current role of health teams in it.  This introduction will include the history of American medicine, a history of the hospital, the development of public and private insurance, innovations in the public and private delivery health services, issues in health manpower (including unionization and nursing), health care regulation, comparative health systems and health planning.  Special emphasis will be given to health teams through case studies and role-playing exercises.

Hal Strelnick, M.D and guest speakers
(718) 920-4678
hsterlni@montefiore.org 

FM13 The Medical-Industrial Complex

This elective gives students research experience in the study of what the New England Journal of Medicine, Fortune and Health/PAC have called the “medical industrial complex”.  Students will conduct supervised study and the research on selected aspect of the health industry, including pharmaceuticals, hospital and medical supplies, health insurance, infant formula and hospital and nursing home corporations among others. 

Hal Strelnick, M.D.
(718) 920- 4678
hstrelni@montefiore.org

FM02 Health Promotion / Disease Prevention / Quality Improvement at the Montefiore Family Health Center 

DESCRIPTION:   This 4 week elective includes participation in chronic disease management program (diabetes, asthma, hypertension, HIV) at the Montefiore Health Center.  Student selects one research area of interest for concentration with end-term presentation on findings and conclusions.  Dr. Rosen and other medical and nursing staff will work with each student to design a rotation, which includes involvement in current activities in patient/provider education and quality improvement. 

OBJECTIVES:

The student will:

• learn evidence-based methods of chronic disease and prevention management in ambulatory care setting
• learn evidence-based methods of quality improvement in ambulatory care

LEARNING EXPERIENCE:

The student will participate in working with a multidisciplinary team; supervised in clinical interaction with patients, and conducting research.

LOCATION:  Montefiore Family Health Center, Medical Director's Office

COURSE DIRECTOR:  Dr. Zachary Rosen
(718) 933-2400
zbr@mindspring.com or zrosen@montefiore.org 
 

GIVEN:  All year round

MAXIMUM:   1 student per month

FEEDBACK:  Students will receive midway feedback and the end of the elective.

EVALUATION:  Final evaluation mid-term and end of cycle regarding (1) participation in multidisciplinary workgroup, (2) interaction(s) with patients, (2) creative and independent research and (3) final presentation.

 
FM24 ECHO Free Clinic Longitudinal Outreach

DESCRIPTION:

This elective is open only to Albert Einstein medical students.  The Walton "ECHO" Free Clinic provides free health care for uninsured adults in the South Bronx, a medically underserved area (MUA).  The clinic sees 20-30 patients each Saturday, offering services such as physical exams, women's health, prescription drugs, lab tests, and social services.  This longitudinal elective trains senior medical students to become Session Coordinators, working with MD/DO/FNP preceptors, MS-III Family Medicine clerks, pre-clinical volunteers and ancillary staff to provide free care to those in need.

OBJECTIVES:

• Understand the challenges facing primary care at a community health clinic in a medically underserved area
• Promote continuity and quality care with effective communication from session to session
• Develop leadership skills by managing a team of pre-med/MS1/MS2/MS3 volunteers
• Learn how to effectively triage and manage patient flow in a busy practice
• Enhance the quality of patient care through interdisciplinary collaboration with social workers, nurses and other ancillary staff
• Understand the socioeconomic challenges faced by free care patients
• Build expertise with an Electronic Medical Record in an ambulatory setting

LEARNING EXPERIENCE:

As a session coordinator (SC), students are in charge of the clinic for that week.  Pre-session duties begin during the week and involve planning for the pre-clinical volunteers and Family Medicine clerks.  At the beginning of every Saturday session, the SC gives an orientation for the volunteers and sets the tone for the day.  Sc duties can be split into "triage" and "flow".  The triage SC focuses on seeing the walk-in patients, fast-tracking them if possible.  The flow SC works closely with the six clinical teams (comprised of family medicine clerks), assigning patients, and providing clinical advice when necessary.  The SC may be asked to assist the MS3 clerks with phlebotomy, in-house labs, and injections.  Additionally, the SC reviews laboratory and referral results with the attending and arranges appropriate follow-up.  At the end of the session, the SC writes a summary and relays any important information for the team next week.

LOCATION:   The ECHO Free clinic is located at 1894 Walton Ave Bronx, NY 10453.  Prior to you first Saturday session, you will be contacted by a Clinic Chair with further directions.

COURSE DIRECTOR: Dr. Amarilys Cortijo
(718) 583-9000
acortijo@institute2000.org

GIVEN:  All year round

MAXIMUM:   20 Albert Einstein student may take this longitudinal elective

FEEDBACK: Students will receive formal  feedback after each session.

EVALUATION:  Students will be evaluated by their attendings, the Clinic Chairs, and/or the elective director.

INPATIENT FAMILY MEDICINE SUB-INTERNSHIPS

FM1 Family Medicine Inpatient Service: Montefiore Medical Center

DESCRIPTION:

The sub-internship is a four to eight week rotation on the Family medicine inpatient unit at Montefiore Hospital.  Students will work with an interdisciplinary team to provide family centered care to adult inpatients.  There will be opportunities to attend core Family Practice and social medicine curriculum activities in the department.

OBJECTIVES:

• to foster an understanding of the family physician's role in hospital management of patients
• to develop clinical decision making and problem solving skills, and the ability to exercise judgment about the appropriate level and options for care
• to develop self-directed learning skills essential for life long learning in the field of medicine
• to understand the psychosocial impact of illness in families of different cultures and socioeconomic backgrounds

LEARNING EXPERIENCE:

Students will work with the team (which also includes nurses, social workers and a clinical pharmacist) to care for patients from the department’s health centers, as well as from emergency department.  Students will have the opportunity to work up admissions, place orders, present patients on rounds, perform procedures and discuss management with consultants.  In addition, they will participate in the team's call schedule.

LOCATION:  Most work will be done on Northwest 7, the Family Medicine inpatient unit, at Montefiore Hospital.  The health care team consists of an attending, 3 residents (two day, and one night float) and four interns (three day, and one night float).

COURSE DIRECTOR:  Barbara Sanders, M.D.
(718) 920-4678
bsanders@montefiore.org

STUDENT MUST ALSO CONTACT SUB-INTERNSHIP COORDINATOR:   Maria Santos, M.D. (718) 430-2900
msantos@aecom.yu.edu

GIVEN:  All year round except July

MAXIMUM:   2 students per month

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  Teaching attending physicians contribute to the final evaluation

FM16 Urban Inpatient Subinternship in Family Medicine @ Beth Israel Family Medicine Residency Program

DESCRIPTION:

The purpose of this rotation is to provide students with an experience in inpatient Family medicine Care.  Family medicine doctors have the ability to see patients in their offices, and then to continue to follow them as inpatients.  As a result, they often have a relationship prior to the admission, which can have beneficial impacts on patient care.  this rotation is designed to give medical students some feel for this type of inpatient medicine.

OBJECTIVES:

• Understand the experiences of "illness" and of becoming a "patient"
• Be available and able to share information and ideas about the sick person's situation to family members and friends, while at the same time respecting confidentiality
• Demonstrate knowledge of common diseases treated in a family medicine inpatient setting
• Develop proficiencies in carrying out an appropriate treatment plan for each patient
• Demonstrate participation with the patient, family and all relevant members of the multi-disciplinary team in making good discharge plans
• Demonstrate knowledge of indications for consultation, and how to communicate effectively with a consultant
• Continue to develop the cooperative skills necessary for a family medicine team to share responsibility for a group of patients.

LEARNING EXPERIENCE:

The students on this rotation will be spending their time in the inpatient setting with the Beth Israel Family Medicine inpatient team, composed of residents and attendings.  There is one call weekend day, and one call night per week.  Family Medicine employs a night float team, so there is no overnight call.  medical students will encounter patients with diagnoses typical to an adult population in a tertiary care center (e.g., pneumonia, CHF, renal failure, HIV / AIDS, alcoholism, and liver failure).

LOCATION:  The setting for the elective is Beth Israel Medical Center.  Wednesday afternoon didactics are at the Institute Family Health site at 16 East 16th Street (near Union Square), and weekly Grand Rounds are Friday mornings at 10 Union Square.

COURSE DIRECTOR:  Ray Teets, M.D.
(212) 206-5228
rteets@institute2000.org

STUDENT MUST ALSO CONTACT SUB-INTERNSHIP COORDINATOR: Maria Santos, M.D. (718) 430-2900
msantos@aecom.yu.edu

GIVEN:  All year round except July and August

MAXIMUM:   1 student per month

FEEDBACK:  Students will receive immediate feedback after procedures and observed counseling and the end of the rotation.

EVALUATION:  The evaluation is compiled from feedback solicited by the supervising physician from the entire faculty who worked with the student.

PALLIATIVE CARE

FM27 Palliative Medicine Consultation Service @ Bronx Lebanon

DESCRIPTION:

The student will have intensive exposure to full spectrum palliative care inpatient activities with underserved African American, Latino and other largely minority patients.

OBJECTIVES:

Students will:

• Interview and examine patients and participate in family counseling with the guidance and assistance of the Palliative Medicine Consultation Service team members
• Present and discuss care options for patients seen in consultation
• Read didactic material on palliative care
• be provided with one-on-one teaching from the attending physician, nurse practitioner and social worker.  Emphasis will be placed on the issues unique to end of life care faced by an inner city, underserved population.

LEARNING EXPERIENCE:.

Students will accompany palliative care team members, including nurse practitioners, social workers, physicians, and patient advocates.  They will also conduct preliminary consults.

LOCATION:  Bronx Lebanon Hospital Center, Milstein 7-F

COURSE DIRECTOR:  Dr. Joseph Sacco
(718) 960-1261
jsaccor@bronxleb.org

GIVEN:  All year round

MAXIMUM:   2 students per month

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  Teaching attending physicians contribute to the final narrative evaluation.

FM28 Palliative Care Elective @ Montefiore

DESCRIPTION:

The purpose of this elective is to introduce fourth year medical students to the philosophy, principles and practice of Palliative Care. During the elective, the student will participate in the multidisciplinary team assessment and management of patients on the inpatient palliative care suite, on home hospice, and throughout the hospital, including patients in oncology, MICU, and the SICU.  Formal didactic sessions will include teaching on pain and symptom management, the palliation of HIV disease, psychiatric issues at the end of lift, advance directives and bioethical issues related to end of life care. 

OBJECTIVES:

• Learn how to assess pain and non-pain symptoms
• Observe palliative care assessment and management for the home visit.
• Recognizes the role of the interdisciplinary team in hospice and palliative care
• Describes how to assess and communicate prognosis
• Describes the use of opiods in pain and non-pain symptom management.
• Describes the use of non-opiod analgesics, adjuvant analgesics, and other pharmocologic approaches to the management of both pain and non-pain symptoms.
• Recognizes common social problems experienced by patients and families facing life-threatening conditions and describes appropriate clinical assessment and management
• Demonstrates knowledge of, and recognizes limitations of, evidence-based medicine in palliative care
• Uses empathic and facilitating verbal behaviors such as: naming, affirmation, normalization, reflection, silence, listening, self-disclosure, and humor in an effective and appropriate manner.
• Demonstrates knowledge of the various settings and related structures for organizing, regulating, and financing care for patients at the end of life.

LEARNING EXPERIENCE:

Students will have an overview lecture on palliative care, read selected review articles and take pre-and post-tests of palliative care knowledge.  Students will assess new and follow up patients on the consultation and inpatient services under the direction of the course directors.  Students will make home hospice visits and participate in interdisciplinary team discussions on patient care.

LOCATION:  Montefiore Medical Center

COURSE DIRECTOR:  Dr. Allen Hutcheson
(718) 920-7327
ahutches@montefiore.org

GIVEN:  All year round except July.

MAXIMUM:   1 student per month

FEEDBACK:  Students will receive formal feedback at the end of the rotation.

EVALUATION:  the course director will complete a 360 assessment form with written comments.

RESEARCH IN FAMILY MEDICINE

FMR Research Elective 

DESCRIPTION:

Students who are interested in conducting primary care research, health services research or epidemiology of urban populations may arrange to work with a faculty member of the DFSM research division.  Students will be matched to a faculty supervisor whose research area and expertise matches the student's interest and goals.

OBJECTIVES:

• Students will identify a topic and specific learning objectives with the faculty supervisor at the beginning of the elective
• students will acquire skills in some or all of the following areas, depending on experience and scope of project:  literature synthesis, study design, data collection, data analysis, and writing for publication
• all students will acquire a basic understanding of human subjects concerns as they relate to their project

LEARNING EXPERIENCE:

Specific learning experiences will vary with the project selected.

LOCATION:  DFSM Research Division and community sites depending on specific project

COURSE DIRECTOR:  Diane McKee, M.D. and colleagues
(718) 430-2154 or (718) 430-2750
mckee@aecom.yu.edu

GIVEN:  All year round

MAXIMUM:   Number of students per month varies depending on interest and project.

FEEDBACK:  Students will receive formal feedback midway and the end of the rotation.

EVALUATION:  The course director will complete the final evaluation.

SOCIAL MEDICINE

F520 Research-Based Health Activism

DESCRIPTION:

Students who are interested in conducting primary care research, health services research or epidemiology of urban populations may arrange to work with a faculty member of the DFSM research division.  Students will be matched to a faculty supervisor whose research area and expertise matches the student's interest and goals.  The course director can assist students with housing.

OBJECTIVES:

By the end of the month, 4th year medical student will:

• Be able to define the concept of "Research based health Activism".
• Be comfortable in describing the organization of the US health system and current policy priorities.
• Be proficient in developing research questions that can be evaluated in quantifiable ways.
• Be able to describe the strengths and weaknesses of different study designs for epidemiologic research.
• Be able to develop an advocacy plan for making use of research findings to influence public policy, including determining short term, intermediate, and long term goals and identifying appropriate targets, allies, and opposition.
• List characteristics of effective advocacy organizations and skills necessary for coalition building.
• Increase their comfort and skills in public speaking.
• Demonstrate proficiency in media relations.
• Prepare and present a project proposal, including background information, research question, methodology and advocacy plan that addresses a health care issue of their choice.
• Will have opportunity to complete their research project and submit findings for publication or presentation at a national meeting.

LEARNING EXPERIENCE:

The month will be composed of three major curriculum segments to aid in developing their project proposal.  The first segment is background on US health policy and politics.  the second segment is epidemiology and biostatistics in order to develop the skills needed to create credible data that will have an impact. Finally, the segment on advocacy skills will give students the tools they need to make use of their findings effectively.  Students will participate in hands on learning about media relations, coalition building, and public speaking.  Learning experiences will also include talks given by nationally renowned policy experts, interactive seminars with physician and non-physician activists, journal clubs and discussion groups, site visits to advocacy organizations, and direct advocacy experiences such as media contracts or lobbying elected officials.

LOCATION:   3rd Floor conference room, Department of Family and Social Medicine, Jerome Avenue, Montefiore Medical Center

COURSE DIRECTOR:   Aaron Fox, M.D.
(718) 920-2990, (718) 579-2500
adfox@montefiore.org

GIVEN:   October only

MAXIMUM:   10 students per month (exceptions can be made with approval)

FEEDBACK:   Students will receive formal feedback midway and the end of the rotation.

EVALUATION:   Evaluation will be based on attendance, effort during seminars, completion of weekly assignments, and completion of final project proposal.

WOMEN'S HEALTH

FM01 Reproductive Health at Montefiore

DESCRIPTION:

Students will participate in clinical sessions at Family Health Center and Williamsbridge to learn about the integration of full spectrum women's health into routine family medicine.

OBJECTIVES: 

• Tailored to needs, interests, and experience of each student.

LEARNING EXPERIENCE:

The month will be composed of clinical care with supervision, reading relevant articles, and reflection on experience/learning after each clinical session.

LOCATION:   Family Health Center and Williamsbridge clinics with Dr. Marji Gold and fellows.

COURSE DIRECTOR:   Dr. Marji Gold and colleagues
(718) 920-2885
mgold@aecom.yu.edu

GIVEN:   All year round

MAXIMUM:    Two students per month

FEEDBACK:   Students will receive formal feedback midway and the end of the rotation.

EVALUATION:   Evaluation will be based on direct experience in the clinic.

FM23 Women's Reproductive Health @ Beth Israel

DESCRIPTION:  

The purpose of this experience is twofold: to provide students with exposure to abortion care at Planned Parenthood and to provide them with experience in a Practice where abortion care is integrated or mainstreamed into the day to day family medicine practice.  They will learn to counsel  women with unintended pregnancies, provide medication abortions and assist with aspiration abortions.  They will also learn proactive contraception prescribing in order to prevent unintended pregnancies, including IUD insertion.

OBJECTIVES:

• Demonstrate skill in informing a patient that she is pregnant and in options counseling. 
• Describe the differences between suction abortion and medical abortion and know the indications 
  and contraindications for each.
• Demonstrate an ability to compare and contrast the systems of health care provided by their family 
  medicine practice as compared to Planned Parenthood's family planning clinic system
• Establish proficiency in counseling women about all birth control methods while being sensitive 
  to the cultural, economic, and psychological issues for any particular patient.

LEARNING EXPERIENCE:

The students on this rotation will observe first trimester abortion training at Planned Parenthood of New York City, under the supervision of family physicians as part of the Clinician Training Initiative.  They will observe the pre-abortion counseling that patients receive in this setting, as well as follow up medical abortion visits.  They will share with residents and fellows in didactic sessions.  The student will participate in the procedural sessions at the Phillips Family Practice where abortion care is also given and will learn to counsel women regarding options for unintended pregnancy and contraception.  They will work in the Saturday woman's free clinic, and will work in the special teen/reproductive care evening session.  The student will work under the reproductive health fellow during her precepting sessions, seeing patients which will be both general family medicine patients as well as contraception and gynecologic issues.

LOCATION:   The settings for the elective will be Planned Parenthood of NYC, Phillips Family Practice and the Women's Reproductive Health Care Free Clinic.  The student will also participate in the weekly journal article discussion that occurs prior to the Wednesday procedure session. 

COURSE DIRECTOR:   Linda Prine and Ray Teets MD
(917) 920-2855
lindaprine@earthlink.net

GIVEN:   All year except July and August

MAXIMUM:    1 student per month

FEEDBACK:   Students will receive formal feedback after each procedure and observed counseling and the end of the rotation.

EVALUATION:   The evaluation is compiled from feedback solicited by the supervising physician from the entire faculty who worked with the student. 

 
WOUND HEALING

FM6 Preceptorship in Wound Healing

Chronic wounds, such as diabetic foot ulcers, venous stasis ulcers, and pressure ulcers, are highly prevalent in chronically ill and elderly patients. They represent a significant public health burden and cause untold morbidity, disability, and mortality. In this elective, students will learn how to evaluate patients with chronic wounds; diagnose underlying factors that lead to physiologically impaired healing; formulate evidence-based treatment plans including topical, medical, surgical, and biologic treatment modalities; apply basic techniques of wound debridement; recognize secondary complications of wounds; and prevent wound recurrence.  In addition, students will gain experience in optimizing patient safety during surgical management of patients with complex co-morbid disease. Upon completion of this elective, students will have the skills to become leaders in saving lives and limbs for patients with chronic wounds. This course is highly relevant to students entering a variety of career paths, including but not limited to family medicine, internal medicine, surgery, plastic surgery, geriatrics, rehabilitation medicine, endocrinology, and infectious disease. Students are strongly encouraged to participate in ongoing research in addition to their clinical work. The elective can be tailored to students’ specific interests, in discussion with the instructor. 

OBJECTIVES:

In this elective, students will learn how to:

• evaluate patients with chronic wounds;
• diagnose underlying factors that lead to physiological impaired healing;
• formulate evidence-based treatment plans including topical, medical, surgical, and biologic treatment modalities;
• apply basic techniques of wound debridement;
• recognize secondary complications of wounds;
• prevent wound recurrence;
• understand health systems needs for wound patients

LEARNING EXPERIENCE:

Activities will include:

• active participation in the inpatient Wound Healing consultation service
• outpatient care of patients with chronic wounds
• weekly nursing home Wound Rounds
• visits can be arranged to related services, e.g. Foot & Shoe clinic, hyperbaric medicine, home visits

LOCATION:   Students will report to Dr. Anna Flattau.  The core schedule will include daily inpatient rounds, participation in bedside debridement, outpatient would clinic 1-2 times per week, and nursing home rounds once per week.

COURSE DIRECTOR:  Anna Flattau, MD, MSc.
(718) 920-4678
annaflattau@yahoo.com
 

GIVEN:   All year round

MAXIMUM:    1 student per month

FEEDBACK:   Students will receive formal feedback midway after each week.

EVALUATION:   The evaluation is compiled by the supervising physician



Indian  Health  Service  Electives  in  Family  Medicine                                                                                                                                 

These away electives are sponsored by the IHS and not AECOM.  These do not require our local Department of Family and Social Medicine approval.  Students are encouraged to apply directly through the elective director.

Shiprock Indian Health Service / Family Medicine

Northern Navajo Medical Center

Shiprock, NM

Director:   Douglas Zang, MD

505-368-7064

Douglas.Zane@ihs.gov

Shiprock Indian Health Service / General Medicine - Pediatrics

Northern Navajo Medical Center

Shiprock, NM

Director:   Jeff Powell, MD

505-368-7064

Jeffrey.Powell@ihs.gov

Whiteriver Indian Health Service

Director:   Dianna Mahoney, MD

928-338-4911

dianna.mahoney@ihs.gov

Zuni Indian Health Service

Zuni, New Mexico

Director:   John Miller, MD

505-782-7456

John.miller@ihs.gov

 

For any further questions regarding elective choices at AECOM/DFSM, please contact Dr. Victoria Gorski, 718-920-6324 or vgorski@montefiore.org