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Curriculum

Third-Year Course

Family Medicine 300 (Principles and Practice of Family Medicine), 152 hours. This required clerkship provides third-year students with an introduction to the principles of Family Medicine as practiced in a community-based ambulatory setting. Student are assigned to clinical faculty members (also known as preceptors) within the state and may live in those communities. Students spend most of the four weeks working directly in office-based patient care under the supervision of the preceptors. During this rotation, student have the opportunity to see patients of all ages as they present with any of the broad range of medical problems seen by family physicians. The patients who present will come with common problems (pharyngitis and sinusitis), chronic problems (diabetes and hypertension), and undifferentiated problems (headaches and abdominal pains). Any and all of these may have biomedical etiologies, have psychosocial dimensions, or be the first symptoms of serious illness. Students see patients that the doctors have known for years as well as patients coming in for their first visit. Students see the doctor caring for whole families-sometimes over several generations. Students see the family physicians interact with other specialists, support staff, and ancillary health-care providers. The clerkship gives you an in-depth view of ambulatory care and the family physicians who practice it.

FAMILY MEDICINE CLERKSHIP SCHEDULE 2007-08

BLOCK 1A	Jul. 9 - Aug. 3, 2007
Introduction	Mon. 7/9 9 am - 4 pm
FM Workshops & Seminars	Tues. 7/10 9 am - 5:30 pm
Midcourse	Fri. 7/20 9 am - 2:30 pm
Presentations and NBME Exam	Fri. 8/31 9 am - 12:30 pm

BLOCK 1B	Aug. 6 - Aug. 31, 2007
Introduction	Mon. 8/6 9 am - 4 pm
FM Workshops & Seminars	Tues. 8/7 9 am - 5:30 pm
Midcourse	Fri. 8/17 9 am - 2 pm
Presentations and NBME Exam	Fri. 8/31 9 am - 12:30 pm
Labor Day Holiday 9/3

BLOCK 1C	Sept. 4 - Sept. 28, 2007
Introduction	Tues. 9/4 9 am - 4 pm
FM Workshops & Seminars	Wed. 9/5 9 am - 4:30 pm
Midcourse	Fri. 9/14 9 am - 4 pm
Presentations and NBME Exam	Fri. 9/28 9 am - 12:30 pm

BLOCK 2A	Oct. 1 - Oct. 26, 2007
Introduction	Mon. 10/1 9 am - 4 pm
FM Workshops & Seminars	Tues. 10/2 9 am - 4 pm
Midcourse	Fri. 10/12 9 am - 4 pm
Presentations and NBME Exam	Fri. 10/26 9 am - 12:30 pm

BLOCK 2B	Oct. 29 - Nov. 20, 2007
Introduction	Mon. 10/29 9 am - 4 pm
FM Workshops & Seminars	Tues. 10/30 9 am - 4 pm
Midcourse	Fri. 11/9 9 am - 4 pm
Presentations and NBME Exam	Tues. 11/20 9 am - 11:30 pm
Thanksgiving Holidays 11/21 - 11/25

BLOCK 2C	Nov. 26 - Dec. 21, 2007
Introduction	Mon. 11/26 9 am - 4 pm
FM Workshops & Seminars	Tues. 11/27 9 am - 4 pm
Midcourse	Fri. 12/7 9 am - 4 pm
Presentations and NBME Exam	Fri. 12/21 9 am - 12:30 pm
Winter Holidays 12/22 - 1/6

BLOCK 3A	Jan. 7 - Feb. 1, 2008
Introduction	Mon. 1/7 9 am - 4 pm
FM Workshops & Seminars	Tues. 1/8 9 am - 4 pm
Midcourse	Fri. 1/18 9 am - 4 pm
Presentations and NBME Exam	Fri. 2/1 9 am - 12:30 pm
Martin Luther King Holiday 1/21
Mardi Gras Holidays 2/4 - 2/5

BLOCK 3B	Feb. 6 - Feb. 29, 2008
Introduction	Wed. 2/6 9 am - 4 pm
FM Workshops & Seminars	Thurs. 2/7 9 am - 4 pm
Midcourse	Fri. 2/8 9 am - 4 pm
Presentations and NBME Exam	Fri. 2/29 9 am - 12:30 pm

BLOCK 3C	Mar. 3 - Mar. 28, 2008
Introduction	Mon. 3/3 9 am - 4 pm
FM Workshops & Seminars	Tues. 3/4 9 am - 4 pm
Midcourse	Fri. 3/14 9 am - 4 pm
Presentations and NBME Exam	Fri. 3/28 9 am - 12:30 pm
Spring Holidays 3/21 - 3/24
Residency Planning Day 3/31

BLOCK 4A	Apr. 1 - Apr. 25, 2008
Introduction	Tues. 4/1 9 am - 4 pm
FM Workshops & Seminars	Wed. 4/2 9 am - 4 pm
Midcourse	Fri. 4/11 9 am - 4 pm
Presentations and NBME Exam	Fri. 4/25 9 am - 12:30 pm

BLOCK 4B	Apr. 28 - May 23, 2008
Introduction	Mon. 4/28 9 am - 4 pm
FM Workshops & Seminars	Tues. 4/29 9 am - 4 pm
Midcourse	Fri. 5/9 9 am - 4 pm
Presentations and NBME Exam	Fri. 5/23 9 am - 12:30 pm
Memorial Day Holiday 5/26

BLOCK 4C	May 27 - Jun. 20, 2008
Introduction	Tues. 5/27 9 am - 4 pm
FM Workshops & Seminars	Wed. 5/28 9 am - 4 pm
Midcourse	Fri. 6/6 9 am - 4 pm
Presentations and NBME Exam	Fri. 6/20 8 am - 11:30 pm

RECOMMENDED REFERENCES

Books

Sloane PD, Slatt LM, Curtis P, Ebell MH, Jacques LB. Essentials of Family Medicine, 4 th ed. Williams & Wilkins, Baltimore, 2002.

This book is available in the bookstore and is recommended as a basic text for this clerkship. It is the most frequently used text in Family Medicine clerkships across the country. It contains chapters on the diagnosis and treatment/management of the most common problems seen in the ambulatory setting. It has a substantial section on preventive care for various age groups. It also has chapters on family issues, the patient in the community, evidence-based medicine, complementary therapies, and the family physician in the changing health-care system. An additional feature of the 4 th edition is a practice test on CD. Although not prepared by the NBME, it can provide you with a series of questions that covers the broad clinical content that is Family Medicine.

Rakel RE, ed. Saunders Manual of Medical Practice, 2 nd ed. W.B. Saunders Co., Philadelphia, 2000. (This text will be checked out to you at orientation.)

This reference book provides an outline of basic medical information on the diagnosis and treatment of the problems most frequently seen in the primary-care office. It also includes guidelines for 64 office-based procedures and an appendix that includes "reference values" for the interpretation of laboratory data.

U.S. Preventive Services Task Force. Guide to Clinical Preventive Services, 2 nd ed.Williams and Wilkins, Baltimore, 1996. (This text should be available in your preceptor's office. The 3rd edition is available online through MDConsult - https://intranet/lsuhsc.edu/mdconsult/ or www.ahrq.gov/clinic/cps3dix.html.
This is the definitive reference for the systematic implementation of preventive services in the primary-care office. Tables for various age groups include recommended screening tests, counseling interventions, immunizations, and chemoprophylactic regimens. Basic recommendations are supplemented for patients considered at high risk. The recommendations are based on a "review of the scientific evidence" as to the effectiveness of the service.
Rudy DR. Family Medicine. Lippincott Williams & Wilkins, 2000.
This book is one of the exam-preparation manuals designed for students studying for USMLE Step 2 and residents studying for USMLE Step 3. While more comprehensive than is required for studying for the clerkship NBME Subject Exam, some students find it helpful as they review for the clerkship final.
Weiss BD, ed. 20 Common Problems in Primary Care. McGraw-Hill, 1999.

Each chapter in this book has a comprehensive overview of the content, with epidemiologic information and discussions on the underlying mechanisms of the disease.

Journals

American Family Physician

Archives of Family Medicine

Journal of the American Board of Family Practice
Some of these journals may also be available in your preceptor's office library or online through MD Consult.

Specific Articles and Journal Supplements

Zimmerman GL, Olsen CG, Bosworth MF. A 'stage of change' approach to helping patients change behavior. Am Fam Physician. 2000 Mar 1;61(5):1409-16.
Prochaska JO, DiClemente CC, Norcross JC. In search of how people change. Applications to addictive behaviors. Am Psychol. 1992 Sep;47(9):1102-14.
Atkins D, Best D, Shapiro EN. The third U.S. Preventive Services Task Force : background, methods and first recommendations. Am J Preventive Medicine. 2001; 20:1-108.

Web Sites

Disclaimer: The sites mentioned below have been reviewed for comprehensiveness, ease of use, and applicability to the study of clinical medicine. However, not every entry has been reviewed by the faculty of Family Medicine. Therefore, students are reminded to use these sites with the same kind of critical assessment they use with other sources of information.

Remember, web sites, unlike print media, are dynamic, sometimes changing in structure from day to day. Therefore, some of the suggestions below may not be the most efficient as the academic year progresses. They should be used as hints to begin your personal search of the site.

1. Medical School Library https://www.lsuhsc.edu/no/library

The above address can be used at distant sites to access the medical school library. You will be asked for your user name and password. Choose OVID, or any other library service, for access to that area. The full range of electronic library services should be available to you at teaching sites away from the main campus, including MDConsult, the Cochrane Library, and the National Library of Medicine. A note from the reference librarians: The OVID site is more efficient and effective for Medline searches than is the one through MDConsult.

2. Family Practice http://www.theabfm.org

This is the official site of the American Board of Family Practice. The section on the "In-Training" practice exam is of most use to students. Although FP residents are the primary target for this practice exam, students might want to use it to get some insight into the content of the NBME. However, it is not a product of the National Board of Medical Examiners; therefore, it is not, strictly speaking, a preparation for the subject exam in Family Medicine.

3. American Academy of Family Practice http://www.aafp.org/facts

At this site you will find the tables listing the results of the CDC's National Ambulatory Medical Care Survey. Table 35 lists the most frequent principal reasons for visits to family physicians, and Table 36 lists the most common diagnoses. Other information about the specialty is also available on the site.

4. British Medical Journal (Electronic BMJ) http://www.bmj.com

This is an excellent source of clinical information for the physician practicing in primary care. There is a section that publishes information particularly pertinent to physicians in the United States. There is also a medical-student section, with links to articles particularly of interest to student doctors. It also provides links to programs around the world for those of you interested in International Medicine.