Family Medicine

Last Updated: October 2013. This clerkship used to be four weeks and has now expanded to six weeks. But now there are different clinical settings that students are required to attend: 1 week of inpatient (usually at Carle), 1 day at Frances Nelson, 2 days at Convenient Care, and the rest of the time in the outpatient setting. The shelf exam is still on Friday, but there is no reading day. So while the clerkship is longer, the amount of time to study remains limited.The shelf is usually on a Friday and  you ARE NOT given reading days to prepare what is a pretty tough exam. There can be significant "down-time" depending on who your preceptor is; this should obviously be used wisely.

If you are taking this after Internal Medicine, you will have an advantage because so much of the material is the same and if you take this later on in your 3rd year (or in your 4th year) it should alleviate some concern because it really only lightly touches on aspects already tested in other clerkships (ie OBGYN and Peds). If you are taking this before Internal Medicine, Peds, OBGYN and/or this is your first rotation, you really need to prepare for the exam. Take advantage of talking with and learning from your preceptor about it. They often know some tips, tricks or resources to use.

The questions in the shelf exam covers a broad number of topics. Some of the studying you did for step 1 will carry over to help you diagnose conditions, especially Goljan's Rapid Review Pathology. You may need to know treatments and management, though, so review basic antimicrobial pharmacology as well.

The biggest thing that surprises students about the shelf exam is the degree of detail in treatment options. The test will often have questions in which the best or first line treatment option is already in the question stem or implied and they want you to know 2nd or 3rd line treatments or additional treatment to add to a regimen. Don't go crazy trying to learn everything, just focus on the really important chronic diseases (HTN, CAD, DM, etc.) and know their treatment protocols.

As far as the nuts and bolts of the clerkship go (if there are 2 or more of you on the rotation):

-There is a lecture every Friday Morning and you are required to go to your preceptor after the lecture is over (usually around lunchtime). These are generally interesting case discussions. For one of these you have to choose a patient who has HTN, Hyperlipidemia, DM, CHF or one of the other common chronic diseases and present a case about them. This is really low-key and is essentially presenting a SOAP note and then the lecturer talks through the pathophysiology, clinical diagnosis and treatment options with you.

-You have a writing assignment that you get midway through the clerkship that is supposed to be one page single-spaced in which you talk about how your perspective has changed during the course in terms of how you view Family Medicine. You get together, read each others' essays and then talk about it one morning with Christine Henrichs the Head of Family Medicine. It is an assignment you should take seriously but not stress about.

-Make sure you give the preceptors plenty of time with the mid-rotation and end of rotation evaluations, it can make them grumpy if you spring those on them at the last minute.