As I mentioned, I am a first year (for a couple more weeks) at CCLCM. Let me give you my week schedule as a sample of a first year CCLCM student:
Sunday Night
finish SAQs (multilpe choice questions for our own benefit) on last week's material. Research and Answer two CAPPs (essays that are anonymously reviewed by expert faculty on cumulative knowledge). Do reading for Monday morning lecture
Monday
8-10 Seminar - "Immunologic Mechanisms of Allergic Disorders"
We are in our "HIM Block" Hematology Immunology and Microbiology block. CCLCM uses a "two pass" method, systems based curriculum. That is, we do mainly "normal" (physiology) the first year, and re-visit the second year for disease (aka pathology). The "systems" based means we group learning around common systems. For example, Cardiology and Pulmonology (heart and lung) are combined in the first block.
Anyway, we broke up for this seminar on Monday into "small groups" (I know, 32 isn't big to begin with, but 8 is comparatively small). Each small group was lead by someone in Immunology. My group was lead by the director of our transplant immunology department.
10-12 Problem Based Learning
We break into 4 groups of 8. We were presented with a case in a narrative format without any prior knowledge of his condition. We developed questions about what we wanted to know (like "what is thrombocytopenia?") and hypothesis about the case (cheat for everyone: cancer is almost always on the differential
). At the end of Monday PBL 4 people volunteer to take a particular topic, research it, and present the information as an 'expert' to all of us on Wed.
12-1 Lunch
Was provided lunch by the Geriatrics staff while listening to two presentations about obesity in the elderly and delirium.
1-5 Geriatrics preceptorship
Accompanied geriatrics fellow to nursing home. Was assigned a patient, did a full history, talked about her current problem list, did a mini mental exam, and performed a focused physical (cardiac, lungs, GI). Wrote up note into patient's chart (for real), and then went and found the fellow and gave her an oral presentation of my exam.
7-10 studied for Tuesday seminar
10-11 vegged out
Tuesday
8-10 We usually have Foundations in Clinical Medicine. However, being the last two weeks of the year, FCM was not scheduled. FCM is our medical humanities course. I actually like it a lot. I have no humanities in my background, but it is great to tackle some of these bigger ideas and concerns of becoming a physician. We had a playwright working with us this year and our reflective writing pieces were incorporated by him into a play he put on for the public a couple of months ago. How cool is that?
10-12 Seminar - "How the Immune System Works in Transplantation"
Large group (32) discussion of the current state of transplant science. CCLCM is an interesting place, because we did one of the first near-total face transplants. Some of my upper classmates were involved in the operation, I hear.
1-5 Longitudinal Preceptorship - CCF Solon Family Health Center
As first years, we spend every other week in clinic seeing patients. We observe our "preceptor", see patients alone, and see patients together. We develop skills that I think are pretty advanced for our stage of learning. My preceptor was delayed at a meeting off site, so I saw the first patient on my own before he was even there. Wow! Never thought I would be able to do that a year ago! This isn't mamby-pamby "shadowing" here. I took the chief complaint, full history, focuses review of systems (ROS), and did a brief physical exam. I actually heard my first extra heart sound and so I investigated further and did a complete cardiac exam. When my preceptor was back, I presented the patient, noted the heart sound, and was given mad props for finding it.
This was my last longitudinal preceptorship before break, and so my preceptor and I got to talking about what LC means. He said it isn't important to be ahead of everyone else at this stage. But rather, he said it will come in handy to have this all be familiar before we hit the wards. Why? Because then we can focus our energies on the art of medicine, the pathology, the issues. I said it was like children learning to read and then reading to learn. That point of inversion denotes the beginning of an explosive phase of learning. I'm not very good at the physical exams, or the oral presentations. But I have a confidence I didn't have before. And I am trying to get this all down before the end of second year. I hope to hit the ground running when 3rd/4th year rolls around. Pretty cool right?
5-7 Dinner
Met a classmate at a nice little open air cafe across from Great Lakes Brewery and the Westside Market. Had musssels and a delightful sandwich with a good beer. Indians were playing so lots of people were out.
Wednesday
8-10 Seminar - Pharmacology - Adverse Drug Reactions
"Large group" seminar given by a PharmD. Interactive seminar going over common symptoms and side effects of many of the antibiotics used in the hospital.
10-12 PBL - Part II
Four 15 min presentations on various topics are given by my classmates. Sometimes these are power point, sometimes "chalk-talks". Other times, they are more interactive, mutli-media, etc. We then turn our attention to the case again. This time, more information is revealed to us. It might be a new disease, a complication of treatment, or new symptoms. Wednesday is sort of like "sweeps week" on TV - there is usually a surprise or some other development that catches our attention. The four people who did not present on Wed are assigned topics to present on Friday.
12-5 Studying
5-7 Dinner
Took a friend to a nice taqueria called Mi Pueblo. There Mole is not the greatest, but it is not from a jar (I can tell). So I give them kudos for making it. Otherwise a pleasant dinner.
Thursday
Usually, Thursday is a free day from CCLCM. There are no seminars, no PBL. Many students take Masters classes on these days. I took CMED401 which was Intro to Clinical Research and I am planning on getting a masters in Clinical Research through the Clinic Research Scholars Program (CRSP - or "crisp"). CRSP is done for the semester, so I actually had nothing scheduled this morning.
2:45 - 5
Sub-Acut
e Preceptorship
Tonight I go to a "step-down" facility and have to do the following:
History taking and a physical examination on patient 60 minutes
Prepare for presenting to the preceptor 15 minutes
Present the history and physical findings to your preceptor 15 minutes
Preceptor feedback 15 minutes
I'll tell you how it goes.
Until then, I am typing on SDN, working on my presentation for PBL, and reading up on seminar material for Friday
8-10 Seminar - "Virology II" focusing on HIV and other retroviruses
Based on the room assignment, it looks like it will be a "large group" discussion tomorrow.
11-12 PBL - I will present my information to the group, along with three other members. Then we will wrap up the case, discuss whether or not we hit all of the learning objectives the course directors wanted us to cover (we are not told ahead of time what they are).
1-2:30 Advanced Research in Medicine
ARM is an intimate venue to listen firsthand thought leaders talk about the current direction of their research. The research is usually tied to the block we are in. For example, Dr. Fairchild will be presenting some of his current work on allograph rejection tomorrow, and it ties in nicely with what we have been learning this past week. Two weeks ago Dr. Tuohy came and talked about about his
breast cancer vaccine research here at CCF.
.....
Lather.
Rinse.
Repeat.