What to take from Family Practice rotation

[pakmand]

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Currently a third year student, just starting family medicine rotation and had a couple of quick questions. What am I supposed to take away from this rotation that I can't get from a medicine rotation? I haven't done medicine yet but the way that i was told to study for the family shelf, is almost identical to the way i should study for the medicine shelf.

I'm at a great one preceptor clinic who lets me see half his patient load independently ~10-15 patients per day. He lets me work the patient up, do the appropriate physical exam, write the script, and the plan (which he approves after I reason out why I did what). While working about 3 days a week at the clinic, I see chronic patients in the morning, acute patients in the afternoon. I feel like i am getting really high yield learning here, but i guess i feel weird that it is not as intense as my pediatric rotation. Is this the norm for family or am I not getting enough from this rotation. BTW, the other 2 weekdays, i am in lectures and i get weekends off. It's really a lax schedule but when i'm working, i learn a lot.

Thanks

 

[kcrd]

Your rotation sounds like a great one. Don't worry about it. Just read on your patients, and try to read generally as well. I used the st francis guide to outpatient medicine, which was good, but out of date in terms of new guidelines for hypertension, etc. the shelf exam is strange; there is no good way to study for it specifically.

Medicine is usually completely inpatient, so it will be very different experience.

 

[Cpt.Hook Hamate]

I just finished my FM rotation this week and took the exam today. I feel the biggest thing I took away from this rotation is what is one of the biggest attribute one must have as a physician and that is to learn to go in to see a patient, take a history, do a PE and come up with a diagnosis within a minute after after you finish that PE. A lot of times all of these steps must be doen in small amount of time with the smallest amount of time going to coming uo with diagnosis and management.

Before, I started my rotation in FM, I used to ask myself why did the IM exam had to be so ridiculous by having us come up with about 100 diagnosis and "what to do next" decisions within two hours. Where in our career would we become even close to being asked to do such a thing?

Once you get into FM you can see it is important to be very efficient with making your medical knowledge surface quick while taking a history and PE because you may have to see so many patients in a day. So I had to learn how to go in a room see a patient, ask lots of relevant questions, do the PE and come up with that Diagnosis and DDX quick because there were many other patients waiting and I wouldn't have the time to go and look up much stuff. It keeps rolling.

So I think coming up with Diagnosis and management steps in a very quick manner is what is good to come away with. The patients waiting in the other examining rooms will appreciate it. And of course, learning to develop relationship with patients the best you can.
On some days, this can be difficult due to time constraints and my preceptor explained to me why and it all made sense.

 

[knjiga63]

Currently a third year student, just starting family medicine rotation and had a couple of quick questions. What am I supposed to take away from this rotation that I can't get from a medicine rotation?

Ideally, family medicine emphasizes the family, especially how relationships affect how the patient tells the story of their illness and how your plan will be affected by those relationships.

Compared to internal medicine, family medicine generally includes more derm, ortho, and psych as well as public health and community medicine. But the biggest differences are emphasis on early and undifferentiated presentation of common diseases and emphasis on outpatient rather than inpatient treatment.

Bert

 

[electra]

Great post, Dr. Hook!
I loved my FM rotation. It was really the first chance I had in third year to really "be the doctor." My preceptor sounds very similar to yours. That is valuable!

I think the other thing about FM is that the patients all seem healthier, even the chronic ones. Almost every patient I saw in IM had multiple problems, all seemed on the brink of going into the hospital. I really found it to be depressing. And the hospital medicine was worse. As much as I enjoy medicine, I would do family first.