Students spend six consecutive weeks in a functioning clinical ambulatory care setting with direct patient care responsibility. At least 40 percent of time is spent in continuity of care, 10-20 percent in acute care, and the remainder in subspecialty and gynecology ambulatory clinics. Psycho-social issues are addressed in the context of patient care with preceptor supervision and psychiatric input.
The experience focuses on ambulatory/primary care issues in clinical medicine, pediatrics and family practice. Students expand existing skills in medical interviewing, and physical diagnosis while developing additional skills in differential diagnosis, health care maintenance, patient counseling and follow-up.
During the course, students are responsible for assuming the role of "student" physician under the supervision of an attending preceptor. In addition to direct patient care responsibility, small-group case discussions and topic reviews of particular importance to primary care form the core of the teaching. Students are required to present an in-depth review of one primary care topic during the course. There will be formal evaluation of the student's performance by attending preceptors based on observation of patient encounters, record keeping, and presentations. Students will be required to evaluate the course and sites.
In order to obtain Honors, students are required to conduct a special project in ambulatory or community health in addition to performing at an honors level, several projects have gone onto research projects.
Students will spend one afternoon (Tuesday) a week back at the SUNY Downstate campus taking ECM III (see description in course selection book), which is considered to be an integral part of Primary Care I. The final grade for Primary Care I will include performance in the ECM III component.
During the six-week Primary Care or Family Practice Clerkship, students will participate in Essentials of Clinical Medicine (ECM) III. ECM III consists of a didactic session and a small group meeting during the student's primary care clerkship. The large group didactic sessions review and elaborate on skills introduced during the first two years of ECM: communication, ethics, evidence-based medicine (EBM), building a partnership with patients. The small group sessions give the students a chance to discuss how to apply and develop these skills in the context of actual patients.
Attendance at all sessions is mandatory. The students are also expected to hand in an EBM exercise, and a brief paper describing the application of all the course skills to a specific patient.