FCM 110 - Orientation 2018

What is FCM 110? Family Medicine clerkship required for UCSF medical students Only third-year clerkship that is entirely outpatient Only third-year clerkship that is longitudinal Equivalent of six-week block clerkship Runs January –December 2018 (“late start” students are July 2018 – June 2019)

FCM 110 Goals Students gain experience in providing: Acute care Chronic care Preventive care Behavioral change Patient continuity Efficient outpatient care Team-based care Family-oriented care Patient education

Logistics Week A Student in clinic with you Week B Student in class at UCSF for FCM seminars plus online cases FCM day is the same day each week and cannot change Excused from block rotations all day for FCM clinic Times that students will miss clinic with you: Vacation Fresno rotation (if applicable) Illness Please contact Sandi Borok with questions….

Note Writing Does my student need to write notes? It is up to the preceptor/site to decide if the student should write notes. Different sites have students write notes on all/some/or no patients, depending on preceptor expectations, EMR, etc. If your student does write notes, they should not stay excessively late to write notes (see below). If your student does not write notes, you should identify another method for the student to demonstrate their clinical reasoning (eg: oral presentation, shadow notes)

How late should my student stay in clinic? Students should leave clinic no later than 30 minutes after the end of the clinical session Often this means finish at Approximately 12:30 for morning clinic Approximately 5:30 for afternoon clinic Students should have at least 30 minutes for lunch Due to traffic and expectations of other rotations, it is important that students leave clinic by 5:30 (unless they are working with you in evening clinic).

How do I help my student learn? Role modeling Giving feedback on oral presentations Direct observation of clinical skills “Homework” - At the end of each session, help the student select a relevant clinical topic for a patient that was seen that day. Ask the student to read briefly about this issue and tell you what they learned at the next session. Help the student apply what they learned to care for their patient.

Why a longitudinal format? Local and national data support better learning in a longitudinal format: Greater continuity with patients, preceptors and health care team More meaningful relationships with patients Improved understanding of chronic illness care, preventive health, behavior change More accurate feedback Greater mentorship by faculty Feeling like “part of the team”

Expectations of Preceptors Orienting the student to your team and clinic Eliciting student learning goals at start, midpoint and end of the rotation Supporting students’ ability to perform an independent history and physical exam Direct supervision of students in sensitive parts of the physical exam and procedures Fostering students’ development of coherent oral presentations and robust differentials Teaching clinical pearls of practice Direct observation of students’ clinical skills Providing feedback to students at least 3 times throughout the year Filling out 2 interim and one end- of-the-rotation online student assessment within 2 weeks of notification Role modeling professionalism Providing mentorship and support of student growth More info on student assessment to follow…

Expectations of Students

Professionalism Prompt Reliable Responsible Respectful Maintains confidentiality Communicates effectively Integrates into the outpatient team If you have concerns, please contact us immediately

Clinical Learning Students should not just shadow! Performing independent patient H and P Developing clear, organized oral presentations Developing and prioritizing a differential for each problem Developing assessments for chronic illnesses based on national guidelines Outlining an appropriate plan Synthesizing recommendations for preventive health Reading about relevant patient care topics Effectively providing patient education Following up with patients Eliciting feedback and integrating suggestions Communicating clearly to patients, preceptors and team Working well with the team

Attendance Students are required to attend all scheduled sessions Block rotations are expecting students to be away for FCM, even if on call or post call Students must notify preceptor, clinic and UCSF if they are ill Students must attend FCM sessions to meet graduation requirement. If a student is absent or tardy more than once, or if you have concerns, please contact us ASAP!

Didactic Learning Between clinic weeks, students have FCM seminars based on fmCASES, an online FCM curriculum used by half of US medical schools Cases cover topics including DM, HTN, HLD, preventive health, etc. Using fmCASES means that even if a student does not see a particular topic in your clinic, they will still learn about it! All students take standardized exam in November (May for late- starting students) based entirely on online cases

FCM 110 Grading Student grade: 65% Clinical assessments by preceptors 15% Attendance and participation in seminar 10% completion of fmCases 10% Final exam

Questions? Please contact us… Roy Johnston Student Programs Manager Roy.Johnston@ucsf.edu Sandi Borok Curriculum Program Administrator Sandi.Borok@ucsf.edu Erica Brode, MD, MPH Assistant Course Director Erica.Brode@ucsf.edu Margo Vener, MD, MPH Course Director Margo.Vener@ucsf.edu

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