E L E C T I V E S

DEPARTMENT OF FAMILY & SOCIAL MEDICINE

The following electives are offered by the faculty of the Department of Family and Social Medicine at Montefiore Medical Center and it’s Family Practice Residency in the Montefiore Residency Program in Social Medicine, 3544 Jerome Avenue, Bronx, New York 10467 and departmental faculty in the Department’s Research Division, 1300 Morris Park Avenue, Mazer Building, Suite 100; Bronx, NY 10461

PLEASE NOTE: ROTATIONS LABELED ALL MODULES MAY OCCASIONALLY BE UNAVAILABLE DUE TO CONFLICTING FACULTY RESPONSIBILITIES. PLEASE CONFIRM AVAILABILITY WITH SPONSORING FACULTY.

FM1 Family Medicine Inpatient Service: Montefiore Medical Center

The Department of Family Medicine offers a four-week elective on its inpatient unit on Rosenthal D in the Moses Division of Montefiore Medical Center. Students will work with an interdisciplinary team of family practice attendings and residents, nurse, social workers and clinical pharmacist to provide family centered care to adult patients admitted from the Department’s health centers and practices in the Montefiore Medical Group and from the Emergency Room. Students will assume primary responsibility for management of patients under the supervision of the family practice residents and attendings. There will be opportunities to participate in the Department’s core family practice and social medicine curriculum activities, to attend conferences and to see patients on half day/ week (if desired) at the Montefiore Family Health Center. In addition to learning traditional inpatient management skills for adult patients, the student will grow in the understanding of the psychosocial impact of illness and in working families of different cultures.

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

All Modules
Maximum 2 students per Module

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

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 his 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. The 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

This elective will address the complexities of caring for people from diverse cultural and class backgrounds, integrating sociological and anthropological concepts into medical practice. Students will have the opportunity to see patients from diverse social-cultural backgrounds at a community health clinic to examine the medical problems in relation to diverse social-cultural determinants. Through readings, videotape reviews and tutorials, they will learn about health benefits and practices, alternative explanatory models, immigrant health issues and it’s impact on doctor-patient relationship and health care in general.

        Eliana Korin, Dipl. Psych.
        (718) 920- 4678
        ekorin@aecom.yu.edu
        All Modules

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

FM4 Family, Systems and Health

This elective will focus on family factors influencing health and the doctor- patient relationship. Topics addressed include somatization, chronic and terminal illness. The student will have the opportunity to learn family functioning assessment techniques relevant to primary care practice. Individual tutorial with group teaching and patient care will be available.

Eliana Korin, Dipl. Psych.
(718) 920- 4678
ekorin@montefiore.org
Joanna Dognin, Psy D
All Modules

Students should contact instructor before registering for this elective.

FM5 Complementary Therapies and Alternative Healing

This elective will provide the student with 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, herbal medicine, etc.

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

Students should contact Dr. Tattelman prior to registering for this elective.

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. Please contact the instructor before registering for this elective.

          Anna Flattau, MD, MSc.
          annaflattau@yahoo.com
          (718) 920-4678
          All Modules

        Please contact the instructor before registering for this elective.

FM7 Adolescent Health Care in a Family & Community Context

This elective will examine the care of adolescents from a family and community perspective. Adolescence as an individual and developmental phase as well as its influence on the family life cycle, will be explored through readings and patient care encounters. The student will have the opportunity to work with adolescents and their families in family-focused, school-based, and street-outreach settings. Discussion and analysis of common adolescent health issues such as violence, suicide, sexuality and family dynamics will occur with a focus on health maintenance and prevention.

         Victoria Gorski, M.D.
        (718) 920-4678
        vgorski@montefiore.org
        All Modules

Students should contact the instructor before registering for this elective.

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

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, identify, health promotion, prevention and clinical practice. There will be opportunity to work with community based organizations such as the Bronx Lesbian and Gay health Resource Consortium (www.blghrc.org) and clinical experience with providers interested and experienced in providing care for this diverse community.

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

Dr. Robert Beil
rbeil@montefiore.org

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

FM9 Health Care for Marginalized Populations

This elective gives the student the opportunity to work as part of the multidisciplinary team, which provides health care to homeless persons, HIV infected individuals living in single room occupancy hotels (SRO) and substance abusers at methadone treatment programs. Care is given in designated shelters, SRO hotels, community based organizations and methadone clinics. Students will be able to understand how care can be delivered outside of the traditional health care system to underserved populations and the challenges associate with non-traditional health care delivery.

         Pamela Mund, M.D.
        (917) 919-1323
        pmund@montefiore.org
       All Modules

Students should contact the instructor before registering for this elective.

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
        hstrelni@montefiore.org
        All Modules

Students should contact the instructor before registering for this elective.

FM12 Understanding Health 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
        hstrelni@montefiore.org
        Module 6B only

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

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
        All Modules

The student should contact the instructor before registering for this elective.

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
        Module 3A only

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

FMR Research Elective

Students who are interested in primary care, epidemiologic or health services research may arrange to work with a faculty member of the Research Division in the department of Family Medicine and Community health on a project related to his or her area of interest. The Department has a strong and diverse research faculty including, Epidemiologist, qualitative researchers and family physician researchers who have a variety of ongoing projects in which students can participate and add to. Some areas of current research include; domestic violence, women’s and adolescent’s health, diabetes, community oriented primary care, chronic illness, culture and health, asthma, health disparities, mental health, end of life care, and car for underserved communities. Interested students will be matched with a faculty supervisor whose research area and expertise best matches the student’s interest and goals.

        Diane McKee, M.D. and colleagues
        (718) 430-2154 or (718) 430-2750
        mckee@aecom.yu.edu
        All Modules, depending upon faculty availability.

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

FM01 Reproductive Health

This rotation involves clinical experience and some qualitative research in reproductive health as an integral part of ambulatory primary care. The student will have the opportunity to work with individual patients as they come for care at the Montefiore Family Health Center under the supervision of Dr. Gold and other family physicians. The training will involve all aspects of reproductive health care and will include advanced training in interviewing and counseling skills to address related psychosocial issues. Students may also participate in ongoing qualitative research in this area, which includes interviewing women and men about their ideas and experiences with various aspects of reproductive health care in the primary setting.

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

Interested students should contact instructor before registering for this elective.

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

The purpose of this elective is to introduce the student to approaches to prevention and quality improvement in primary care practice. Students will be involved in patient and provider education activities related to preventing important chronic diseases. These will include smoking cessation and other lifestyle changes, which can improve outcomes in patients with diabetes and hypertension, and prevent or forestall the development of such problems. The student will work directly with Dr. Zach Posen, Medical Director of the Montefiore Family Health Center, a federally funded community health center and residency-training site in a culturally diverse, medically underserved neighborhood. 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.

Dr. Zachary Rosen
(718) 933-2400
zbr@mindspring.com

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

FM03 School-Based Health Care

The Montefiore School Health Program is offering clinical electives for fourth year medical students on School-Based Health Care. Electives may take either of the following forms:

Full time, four week elective is School-Based Health Care (SBHC).
One session per week for 4 weeks elective in Adolescent Reproductive Health Care.

The full-time elective will involve seminars on core SBHC topics including journal discussions and case presentations. Students will also see patients at the site with preceptors, which include pediatricians, family physicians and nurse practitioners. Opportunities will be provided to conduct group activities on well established curricula like the “Open Airways for Schools” and the “Cooking with Kids”. Students will also gain exposure on the conduct of interdisciplinary approach to patient care.

The limited four-week elective will focus on clinical encounters with adolescent patients in the SBHC. The experience will also include the conduct of family planning and STD prevention groups.

Dr. David Appel
(718) 696-4070
dapple@montefiore.org
All Modules

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

FM23 Management Practicum

This elective is offered to students interested in learning first-hand how a clinical practice is run administratively. Participating students will become familiar with Billing and Coding, Managed Care Principles, office staff coordination and triage skills. Students will also learn ICD-9 CPT coding, E&M Coding and insurance information. At the end of the elective, students will have increased quality of care, reimbursement and time management skills.

        Dr. Russell Perry
        (718) 901-8749 or (718) 901- 8722
        sbirth@bronxleb.org
        All Modules

Interested students should contact Dr. Perry’s assistant, Ms. Star Birth, before registering for this elective.

FM24 Inner City Medicine Inpatient Service- Bronx-Lebanon Hospital Center

This is a four-week elective working as a subintern on a Family Medicine Inpatient Unit staff by Family Practice Residents and Attendings, including a full-time Family Practice Hospitalist. The unit uses an interdisciplinary, holistic approach to care working closely with nurses, social workers and others. Students will be assigned responsibilities similar to those of a Family Medicine Intern with patient load adjusted for skill and interest of the student; participation in daily teaching rounds, morning report and weekly grand rounds is expected. Dr. Sacco has a particular interest in Pain Management and the unit delivers care to a large number of patients with Sickle Cell Anemia, as well as, the more common diagnoses such as, HIV, diabetes, hypertension and asthma. An opportunity to see ambulatory patients at Fulton Family Practice can be arranged one half day per week if desired.

        Dr. Purnima Garg
        (718) 901-8749 or (718) 901- 8238
        pgarg@bronxleb.org
        All Modules

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

FM25 Inner City Family Medicine Ambulatory Care Externship- Bronx-Lebanon Hospital Center

The Department of Family Practice offers 4 week elective in one Bronx Lebanon Family Practice Ambulatory Care site (Ogden). Students will work with a multidisciplinary team of family practice attendings, residents, nurses and behavioral scientist. Students will assume primary responsibilities for the management of ambulatory care patients under the supervision of family practice attendings and residents. Students will have the opportunity to participate in family practice specialty clinics, including colposcopy, circumcision and minor surgical procedures. Students will have the opportunity to attend grand rounds, journal club and senior seminars. In addition to learning the traditional outpatient management of patients for common diseases, the students will gain experience in the multidisciplinary approach to complex disease states like HIV and Hepatitis C.

        Dr. Fabienne Daguilh
        (718) 466-3225
        fdaguilh@bronxleb.org
        All Modules

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

FM26 Understanding the Spiritual and Religious Dimension of Patients

This four-week elective course explores spirituality and religion as it impacts patients’ 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. Opportunities include joining a hospital chaplain on patient visits; interviewing patients with chronic illness and pain; caring for patients and their families with terminal illness and attending home visits to geriatric patients to explore end of life issues. Complementary and alternative practices within the realm of spirituality will be included. Students needing to complete their ISP project requirement relevant to this elective can be mentored.

Bi-weekly seminars focus on discussion with core faculty facilitators and invited guests regarding the intersections of patients’ spirituality with clinical issues, assigned readings and research studies. In addition, students are encouraged to reflect on their own religious and spiritual selves as it impact the doctor-patient relationship and sustains the practice of humanistic medicine.

        Mimi McEvoy, NP, MA
        Principal Associate, Pediatrics
        (718) 430-3167
        mcevoy@aecom.yu.edu

        Dr. Elisabeth Alderman
        Clinical Professor, Pediatrics
        (718) 920-6614
        ealderma@aecom.yu.edu

         Dr. Victoria Gorski, M.D.
        Associate Professor, Family Medicine
        (718) 920-5521
        medicinevgorski@motefiore.org

         Dr. Deborah Widerski, M.D.
         Assistant Professor, Family Medicine
     (718) 920-5521
        dwiderski@montefiore.org

Module 6B only
Maximum 6 students

Interested students should contact Mimi McEvoy for permission before registering for the elective.

FM27 Palliative Medicine Consultation Service

The Department of Family Medicine offers a four-week elective with the Palliative Consultation Service at Bronx-Lebanon Hospital Center. Students will work with an interdisciplinary team comprised of a family practice attending, a palliative care trained nurse practitioner, a palliative care trained social worker and a hospice nurse liasion to provide patient and family centered palliative and hospice care to serious and terminally ill patients through out Bronx-Lebanon, including MICU, CCU, ventilator unit, family practice inpatient unit, all medical and surgical floors and a planned hospice inpatient unit. Students will interview and examine patients and participate in family counseling with the guidance and assistance of the Palliative Medicine Consultation Service team members and will be expected to present and discuss care options for patients seen in consultation. Students will read didactic material on palliative care and 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.

         Dr. Joseph Sacco
        (718) 960-1261
        jsaccor@bronxleb.org
Interested students should contact the instructor before registering for this elective.

FM28 Palliative Care Elective

The purpose of this elective is to introduce fourth year medical students to the philosophy, principles and practice of Palliative Care. Both two week and four-week blocks are available, with a maximum of one student per block. 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.

Working closely with physicians, nurse practitioners, social workers, psychiatrists and others, elective students will gain proficiency in assessing the physiological, psychological and spiritual responses that occur at the end of life. They will apply and develop communication and counseling skills for individuals and their families as they face death, gain the ability to prioritize pharmacological and non-pharmacological management for patients with complex symptoms, and learn how to identify and manage common clinical emergencies in palliative medicine.

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

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

FM29 Elective in Global Health

There are a limited number of position 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.

        Dr. Matthew Anderson
        (718) 933-2400
        bronxdoc@gmailcom

        Dr. Smith
        vze2x6qm@verizon.net
        All Modules

Interested students should send their CV’s and a cover letter to either Dr. Anderson or Dr. Smith before registering.

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

FM30 Medical Spanish Immersion in the Bronx

This four-week elective will provide a Medical Spanish Immersion experience in a family medicine practice in the Bronx. Students will work with an interdisciplinary team at the Mount Hope Family Practice (130 West Tremont) and will interview and examine mono-lingual patients in Spanish. Two mornings a week, students will receive Medical Spanish instruction at the medical school. Materials and on-line tutorials will also be provided. Students will participate in group counseling sessions of Spanish speaking patients regarding Diabetes and other health related issues with the health educator. Materials on specific health education issues will be provided. Emphasis will be placed on the improvement of language skills, such as comprehension and the ability to interview, conduct physical exams, and present the case in Spanish. In addition, students will be expected to provide health education relevant to the patients in this clinic and/or community in a culturally and linguistically appropriate manner.

Preceptor: Maria Marzan, EdD, MPH

Intermediate Spanish is required (assessed by instructor).

Module 6A

Contact information: Dr. Maria Marzan
mamarzan@aecom.yu.edu
(718) 430-3419

For any further questions regarding elective choices at AECOM/DFSM, please contact Dr. Victoria Gorski,

718-920-6324 or vgorski@montefiore.org