Saturday, April 7, 2012

Family Medicine Activist: Med Student Training in Family Medicine

"The AAFP recommends that the curriculum of every medical school have adequate preclinical and clinical student exposure to family medicine with the further directive that, where such is lacking, every possible means of correcting the deficiency be exercised. The AAFP is committed to making every effort to ensure that family medicine in the undergraduate curriculum with appropriate exposure to role models on the faculty be instituted in all medical schools.

The AAFP recommends that all medical schools provide mandatory family medicine clerkships completed by the end of the third year, and elective preceptorships and clerkships to their students.
(1973) (2008)"  From the American Academy of Family Physicians

During their clinical training, medical students get exposure to Family Physicians via their clinical clerkships,  learning from Family Physicians in a Family Medicine practice location such as a private practice-like my office-an academic setting, a community health center, etc.).  They interact with patients every day during this four to eight week patient care rotation, getting first hand experience with their clinical knowledge and skills and their mentors who are Family Physicians (and residents training to be Family Physicians) and support staff.  The clinical learning is usually enjoyable for the medical students who start to realize that they know something useful to real live patients.

The students usually get exposed to a broad range of conditions and diseases  as well as a "womb to tomb" age distribution of patients.  This also heightens their career and specialty selection planning skills as they start to realize what they like and don't like to do.  They may feel very comfortable both in the office and in the hospital with Family Medicine patients (under the supervision of their Family Medicine Faculty).

It may challenge them to care for newborns (or learn to circumcise the baby boys) or prescribe medications and treatments for 90 year-old patients with multiple organ problems such as kidney or heart failure.  They may be especially satisfied with the rapid improvement of the patient with pneumonia.  They may notice the need to help relatives to better understand some aspects of the end of life planning for their in office or hospitalized relative with  dementia.  Well child exams in the Family Medicine office may appeal to the student as another aspect of their future chosen specialty.  Variety is the daily fare in Family Medicine.

They also expand their learning and understanding of the role of a family physician in the medical community and in patient lives.  Once the medical student knows that there isn't always a "right answer" to the patients problem they start to allow the patient to be their unique self, not so much the person the medical student (or their family of origin dogma) wants them to be.  This can be fun for those who have more comfort with uncertainty and think like a relationship-based, family oriented generalist.

Self understanding is a part of every experience in medical school, hopefully enabling the student to understand which specialty best suits them so they may best serve patients.  The Family Medicine experiences are required for students, so all get the exposure to various aspects of the specialty and many different faculty.  Less than 9% choose the specialty for their own, but all get some understanding of the content of the specialty and the type of relationships one may have as a Family Physician.

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