Dal Alert!

Receive alerts from Dalhousie by text message.

X

Clerkship Objectives

The knowledge and skills relevant to patient care.

By the end of the family medicine rotation, a Dalhousie medical student will have the knowledge, skills, and attitudes relevant to the care of patients in a community-based family medicine setting by providing acute and chronic care for patients of all ages and incorporating preventive health care and risk reduction.

Expand the following sections to see the rest of the document.

Key Objectives

By the end of the family medicine rotation, the student will be able to:

  1. Recognize that the patient-physician relationship and continuity of care are central to the practice of Family Medicine.
  2. Describe how illnesses present at an early undifferentiated stage in the Family Medicine environment when compared to the other clinical settings.
  3. Demonstrate effective communication skills in carrying out a patient-centred interview, exploring the patient’s illness experience, personal history and social context.
  4. Perform a physical examination, which is accurate and appropriate to the presenting problem and sensitive to patient comfort and interpret the findings.
  5. Describe the indications for, risks of and methods used in the common investigations, diagnostic and interventional procedures used for the common problems and presentations in a Family Medicine setting and interpret the results.
  6. Demonstrate clinical problem-solving skills, including the ability to diagnose and to initiate management (both non-pharmacological and pharmacological) with supervision, of the common problems and presentations in a Family Medicine setting.
  7. Communicate effectively, both orally and in writing, including documenting in patient records, making case presentations, writing prescriptions, writing referrals and in negotiating and summarizing the management plan with patients in a patient-centred manner.
  8. Demonstrate an understanding of common ethical issues in practice such as confidentiality, consent and patient autonomy.
  9. Recognize the importance of personal health on one’s ability to care for others.
  10. Introduce health promotion and disease prevention principles and activities appropriate to particular patient populations into the clinical encounter using evidence-based guidelines.
  11. Demonstrate self-directed life-long learning and will use evidence-based resources to provide patient care.
  12. Identify and use or liaise with appropriate resources to support the delivery of patient care including inter-professional teams and community resources.

Content Objectives 1- 5: Skilled Clinician

THE FAMILY PHYSICIAN IS A SKILLED CLINICIAN

By the end of the rotation the student will be able to:

  1. Describe how illnesses present at an early undifferentiated stage in the Family Medicine environment recognizing:
    • the ill-defined nature of early presentations
    • the greater uncertainty
    • the use of time as a diagnostic tool
  2. Demonstrate effective communication skills in carrying out a patient-centred interview, exploring the patient’s illness experience, personal history and social context by:
    • routinely exploring the patients’ experiences of illness—their feelings, ideas, effects of the illness on function and expectations for care.
    • exploring the patients’ personal history and context (family, job, school, geography, environment, etc.)
    • conducting shared decision making/finding common ground—supporting patients having as active a role in all decisions affecting their health care as they desire
    • providing patient education
  3. Demonstrate a patient-centered approach to history-taking, physician examination, diagnostic testing and clinical problem-solving skills, including the ability to diagnose and to initiate management (both non-pharmacological and pharmacological) with supervision, of the common problems and presentations in a Family Medicine setting.

  4. Describe the indications and demonstrate the technique used for the following procedures:
    • Injections (Subcutaneous and Intramuscular)
    • Pelvic Exam/Pap Test
  5. Demonstrate the technique for the following examinations:
    • Vital signs
    • Breast Exam
    • Newborn Exam (up to 4 weeks of age)
    • Rectal Exam
    • Peripheral Neuropathy Testing/Monofilament Testing    

Content Objectives 6 & 7: Patient-Physician Relationship

THE PATIENT-PHYSICIAN RELATIONSHIP IS CENTRAL TO THE ROLE OF THE FAMILY PHYSICIAN

By the end of the rotation the student will be able to:

  1. Recognize that the patient-physician relationship and continuity of care are central to the practice of family medicine by:
    • respecting differences in beliefs and backgrounds and treating the patient as a whole person in a non-judgmental manner
    • establishing professional relationships with patients, families, communities and colleagues
  2. Demonstrate how to obtain informed consent for an investigation, procedure or management from a patient

Content Objectives 8 & 9: Defined Practice Population

THE FAMILY PHYSICIAN IS A RESOURCE TO A DEFINED PRACTICE POPULATION

By the end of the rotation the student will be able to:

  1. Introduce health promotion and disease prevention activities into the clinical encounter, demonstrating:
    • awareness of stages of change theory
    • awareness of systems for health promotion and prevention activities in the office
  2. Utilize critical appraisal skills and evidence-based resources to prepare a 10-minute presentation for their colleagues.

Content Objective 10: Community-Based

FAMILY MEDICINE IS COMMUNITY-BASED

By the end of the rotation the student will be able to:

  1. Describe the types of services provided by various community resources/services/agencies within the community in which the student has worked and the relationship between these organizations and family physicians in providing care to the patient population.

Seminar Objectives

Seminar: Screening and Health Promotion, Parts 1 and 2

By the end of the seminar, the medical student will be able to:

  • Demonstrate a general approach to incorporating periodic health examinations/preventive care within a practice.
  • Determine patient risks for common gender/age specific conditions.

Seminar: Well Baby/Child

By the end of the seminar, the medical student will be able to:

  • Utilize an evidence-based standardized health maintenance guide to monitor development of newborn/infant such as Rourke Record.
  • Educate parents about developmental parameters, child safety, behaviour issues, nutrition and health promotion which is age appropriate.
  • Demonstrate and 18-month screening physical.
  • Evaluate an individual's child risk for harm.
  • Know when to refer a child for developmental delay.

Seminar: The Chronic Cough

By the end of the seminar, the medical student will be able to:

  • Explain underlying pathophysiology of asthma to patients and/or family members.
  • Assess asthma control at follow-up.
  • Identify modifiable triggers for patients with asthma.
  • Describe the different medication delivery methods (and relevant compliance/educational issues.)
  • Describe major medication categories for asthma, including mechanism of drug action, particularly SABA and ICS, their benefits and risks.
  • Explain underlying pathophysiology of COPD to patients and/or family members.
  • Describe major medication categories for COPD, including mechanism of drug action, particularly SABA and LABA, their benefits and risks.

Seminar: Breastfeeding

By the end of the seminar, the medical student will be able to:

  • Educate patient on the benefits of breastfeeding.
  • Counsel a patient on how to breastfeeding.
  • Describe common complications such as engorgement and mastitis and their management.

Seminar: Family Violence

By the end of the seminar, the medical student will be able to:

  • Describe factors contributing to violence.
  • Describe the cycle of abuse.
  • Assess risk and negotiating a safety plan.
  • Recognize signs of imminent violence.

Seminar: Women's Health

By the end of the seminar, the medical student will be able to:

  • Develop an evidence-based treatment plan for menstrual irregularities which includes lifestyle counselling, non-pharmacological and pharmacological modalities.
  • In considering the initiation of a contraception method, obtain an appropriate medical and sexual history (e.g. migraines, unprotected intercourse, smoking, depression, contraindications for common contraceptive methodologies).
  • Be able to list and explain the absolute contraindications for hormonal contraception.
  • Counsel patients on contraceptive options including:
    • consideration of patient preferences and values
    • risks and side effects
    • contraceptive methods and devices, both permanent and non-permanent
    • benefits & relative efficacy
    • barriers to access (e.g. cost)
    • proper use including initiation
    • potential drug interactions
    • emergency contraception
  • Conduct a patient-centered interview and focused physical exam to assess for signs and symptoms of menopause.
  • Elicit possible menopausal associated conditions such as mood disorder, sleep disturbance, etc.
  • Develop a management plan for a patient with menopause with investigations, if needed, and treatment modalities ensuring no contraindications exist.
  • Counsel menopausal women about preventative health measures (osteoporosis, mammography – see Preventive Health Care).

Seminar: Hypertension

By the end of the seminar, the medical student will be able to:

  • Define how to diagnose hypertension in a family practice setting for different patient groups, and identify the blood pressure targets for these groups.
  • Describe end-organ damage from hypertension and how to assess a patient for these.
  • Propose an initial diagnostic workup for a patient with a new diagnosis of high blood pressure to determine if there is a secondary cause for hypertension (versus essential hypertension).
  • Define the diagnostic and treatment targets for various groups of patients with high blood pressure.
  • Propose a treatment plan (incorporating non-pharmacologic and pharmacologic options) for a patient with a new diagnosis of high blood pressure.

Seminar: Rashes

By the end of the seminar, the medical student will be able to:

  • Describe skin lesion(s) using appropriate terminology (e.g. macule/patch, papule/plaque, vesicle, bulla, erythematous, ulcer, etc.)
  • Apply the ABCDE’s (Asymmetry, Borders, Colour, Diameter, Evolving over time) to identify malignant melanoma.
  • Recognize and propose initial management for the following conditions:
    • Atopic dermatitis/contact dermatitis
    • Psoriasis
    • Acne
    • Infectious causes
    • Viral (exanthems, herpes, shingles, molluscum contagiosum, warts)
    • Bacterial (impetigo, cellulitis)
    • Fungal (tinea, candidal dermatitis)
    • Drug-induced reactions
    • Drug eruptions
    • Anaphylaxis/Hives
  • List the indications for biopsy and/or referral (e.g. treatment failure, uncertain diagnosis, possible malignancy).
  • Identify risks of long-term topical steroid use.

 
 
Approved by Dalhousie Family Medicine Undergraduate Medical Education Committee, July 2013.
Resources updated August 2016
Reformatting for Deadulus Map, August 2016