As a third year medical student, you can continue to explore a career in family medicine through your required family medicine clerkship. You can select a site which is rural, urban inner city, suburban or HMO. Clerkship staff are very helpful in assisting you choose a site that meets your needs and interests. The MedWeb resources for the family medicine clerkship are a good place to start looking. There will be an opportunity in the Spring for third year students to meet with 4th year students who match in family medicine to socialize and hear their stories and experiences in deciding on a career in family medicine. You may consider continuing your community medicine involvement by doing some extra shadowing work at a community clinic or residency where you may be interested in applying.
Be sure to meet with your advisor to plan out year 4.
How to Get the Most Out of Your 3rd Year
As family medicine is a subset of primary care, your focus during your third year should be broad-based. Much of primary care is out-patient based and much of your third year is in-patient based. However, many family medicine physicians continue to do in-patient medicine rounding for their group and some work as hospitalists and in intensive care units.
All family physicians will need to know how to recognize the acuity of an illness that necessitates a hospitalization. Additionally, family physicians do post-hospitalization follow up care, surgical and pre-operative clearances and post operative wound care. Family physicians do many office based surgical procedures. Becoming comfortable with suturing and wound care is an important skill to learn on your hospital rotations.
Family physicians also do maternity care which is family centered. This would include pre-natal care, delivering babies and newborn care. As family physicians often do “cradle-to-grave medicine, many will be “breaking bad news”, holding family conferences and discussing terminal care and end-of-life plans with families and patients.
The many “common illnesses that bring patients into the hospital (diabetes, hypertension, coronary artery disease,etc.) are key illnesses to become very familiar with their diagnosis and management. Being attentive to these opportunities during your third year clerkships would be helpful.
Lastly, family physicians are integral to the health care team in coordinating care “for the medical home for patients.” Learning to work with the multiple specialists in a hospital is integral to this process.
Family Medicine Clerkship
The Family Medicine Clerkship was awarded the “Outstanding Required Clerkship Award” for 2008. This award is presented to the clerkship voted “most outstanding” by the graduating class!
The Family Medicine Clerkship is a 6 week ambulatory, primary care experience. Students work alongside their preceptors during all of their usual clinical activities in order to optimally experience the true nature of a family medicine practice. Because of this preceptorship experience, students often enjoy a close, collegial relationship with their preceptor and gain significant autonomy with their patients.
The first week is spent at the HSC campus in a variety of interactive and case-based activities, both in and out of the classroom. The next 4 1/2 weeks are spent in one of a variety of pre-approved, community-based practices of board-certified family physicians, located all across the U.S. Students return to the HSC campus for final activities and exams on the last Thursday and Friday of the rotation.
Students choose a preceptor from the list of established preceptors. Once they have decided on a preceptor, students should contact the clerkship coordinator as soon as possible since the most popular sites fill up quickly.
Family Medicine Residency Programs
Family medicine residencies should strive to teach residents all procedures within the scope of family medicine. They should, at a minimum, teach residents those procedures done by a substantial number of practicing family physicians both in the ambulatory and inpatient settings. Whenever possible, family physician faculty should teach these procedures.
Procedures and skills associated with maternity care and hospital care remains essential parts of family medicine residency training and clinical practice. Each family medicine residency must have faculty, board certified in family medicine, who actively teach, have clinical privileges and practice maternity care. As the scope of family medicine changes, family medicine residencies strive to teach new or emerging procedures or techniques that are within the scope of family medicine.
For a full listing of residencies by region, please visit the MS III/IV Clerkship.
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