GOALS:

a. To obtain an understanding of the principles, practices, and scope of Medicine.

b. To understand the approach to and the medical management of adult patients.

EDUCATIONAL OBJECTIVES:

a. Assess the important information that is needed to be obtained regarding the patient's current illness and the methods of obtaining this data.

b. Obtain concise and yet complete medical histories such that a more experienced physician could not obtain additional information at the time.

c. Obtain additional information about the patient from ancillary sources (old records, family members, etc.)

d. Assess each item in the problem list and provide an appropriate differential diagnosis and diagnostic and/or treatment plan where indicated.

e. Support the diagnostic and treatment plan by assessment of the risks and benefits to the patient.

f. Develop appropriate communication skills with regard to discussions with the patient and/or family members about his illness treatment and prognosis.

g. Follow patient's hospital course to develop an understanding of the diseases process and its response to treatment. Have the ability to discuss the patient's condition at any point in time.

PERFORMANCE OBJECTIVES:

a. Ability to take a history independently (minimum one per week)

b. Ability to perform a complete and comprehensive physical examination (minimum one per week). This includes the ability to record the data in a proper and appropriate manner so that it can be used by other physicians and medical professionals.

c. Appropriate use of the following diagnostic equipment:

1. Stethoscope

2. Opthalmoscope

3. Otoscope

4. Percussion Hammer

5. Tuning Fork(s) (128 cps and 512 cps) for both hearing and neurological evaluation.  ev

d. Interpretation of data from the following tests:

  1. Complete blood count with differential

  2. Blood chemistry (SMA-12 or equivalent)

  3. Urinalysis

  4. Arterial blood gases

  5. CSF analysis

  6. Culture and sensitivity (with gram stain)

  7. Glucose tolerance test

  8. Arthritis panel (RA latex, ASO titer)

  9. Pulmonary function tests

10. ECG interpretation

11. X-rays interpretation

e. Ability to assist and/or perform the following procedures:

1. Venipuncture

2. IV catheter insertion (including CVP)

3. Arterial puncture

4. Thoracocentesis

5. Electrocentesis

6. Nasogastric intubation

7. Endotracheal intubation

8. Venous cutdown

9. Lumbar puncture

f. Develoment of proper documentation skills:

1. Admissions summary

2. Orders

3. Progress and prodedure notes

4. Discharge summary

g. Case report and presentation (minimum one per week)

The student is responsible for the presentation of a case report of the patient he has worked up. This report should include the following data and be presented in a written form (at the attending physician's discretion).

1. History and physical examination

2. Problem list

3. Differential diagnosis

4. Diagnostic and treatment plan

5. Objective data

6. Hospital course to date

7. Supporting documentation from the literature

The clerkship is designed as a full-time assignment to clinical medicine. Under supervision, the student will be assigned to obtain concise and complete medical histories. He/she will be trained to access the information obtained regarding the patient's current illness, evaluate laboratory data and arrive at an appropriate differential diagnosis and diagnostic and/or treatment plan.The student will be encouraged to develop appropriate communication skills with regard to discussions with the patient and/or family members about his/her illness, treatment and prognosis. He/she will also be guided to follow the patient's hospital course to develop and understand the disease process and its response to treatment and will also be expected to gain the ability to discuss the patient's condition and progress at any given point in time.