Boston University Clerkship Program

Anna DePold Hohler, MD Assistant Dean, Office of Academic Affairs Director, Medical Student Education for Neurology Associate Professor, Department of Neurology

Boston University School of Medicine – By the Numbers

8 Pathways to the medical degree 12 Core research facilities 14 Centers of Excellence 15 Affiliated neighborhood health centers 20 Research centers and institutes 25 Affiliated hospitals 25 Departments in basic and clinical sciences 25% Increase in NIH funding in FY ’09 32nd U.S. News & World Report 2014 Ranking of U.S. Medical Schools, Best Research; 35th Best Primary Care 100 Applicants for every seat in the entering class 600 Funded research programs 1,159 Faculty 1,635 Students 6,200 Electronic library resources and bibliographic databases 7,733 MD, PhD, and MMS alumni $180 million NIH-funded grants $282 million Total research grants

BU CARES The BU CARES Institutional Learning Objectives The acronym BU CARES stands for the BUSM education program’s seven fundamental objectives, which describe the knowledge, skills, and attitudes that every graduate should possess. The principles behind BU CARES guide the management of the curriculum, inform student assessments, and form the basis of all course and clerkship learning objectives. The BUSM Graduate: (The linked ACGME competencies are in parenthesis) Behaves in a caring, compassionate and sensitive manner toward patients and colleagues of all cultures and backgrounds, using effective interpersonal and communication skills (Interpersonal and Communication Skills; Professionalism) Uses the science of normal and abnormal states of health to prevent disease, to recognize and diagnose illness and to provide an appropriate level of care (Medical Knowledge; Patient Care) Communicates with colleagues and patients to ensure effective interdisciplinary medical care (Interpersonal and Communication Skills; Patient Care) Acts in accordance with the highest ethical standards of medical practice (Professionalism) Researches and critically appraises biomedical information and is able to contribute to the advancement of science and to the practice of medicine (Practice-based Learning and Improvement; Medical Knowledge) Exhibits commitment and aptitude for life-long learning and continuing improvement as a physician (Practice-based Learning) Supports optimal patient care through identifying and using resources of the health care system (Systems-based Practice; Patient Care)

Opportunities for Collaboration First Year Students: In the first year Introduction to Clinical Medicine course (ICM-1) students complete ten sessions shadowing a clinician-mentor in the mentor’s practice setting.

Second Year Students: In the second year Introduction to Clinical Medicine course (ICM-2) students spend two half days with an instructor in the ambulatory setting as part of the office sessions.

Third Year Students: Required clerkships, 4-8 weeks in length, in the areas of Internal Medicine, Surgery, Family Medicine, Pediatrics, OB/GYN, Psychiatry, Neurology, Radiology

Fourth Year Students: Required 4-week clerkships in Ambulatory Medicine, Surgery Subspecialties, and Geriatrics

Physician’s Assistant Program: Students complete 56 weeks of clinical training in 12 specialty areas

Advantages of Collaboration

• Joy of the clinical experience which decreases burnout

• Utilization of the students as patient evaluators (vitals, med rec, allergies, ROS, meaningful use) and patient educators

• Improved experience for patients

Benefits to Institutions

• BUSM provides compensation to institutions who collaborate in teaching

• Students often chose one of their clerkship sites for residency

• Residents become familiar with the system and are more likely to stay on as staff

BUSM 3rd year required clerkships

• Internal Medicine- 8 weeks

• Surgery- 8 weeks

• Family Medicine- 6 weeks

• Pediatrics- 6 weeks

• OBGYN- 6 weeks

• Psychiatry- 6 weeks

• Neurology- 4 weeks

• Radiology- 4 weeks

BUSM required 4th year clerkships

• Ambulatory Medicine- 4 weeks

• Surgery Subspecialties- 4 weeks

• Geriatrics- 4 weeks

Time management: Student in shared room with attending

• Faculty development and pre positioning

• Students need to have the patient list the day before to prepare

• Attending gets a brief history and types while the patient examines

• Student does vitals and performs a brief exam

• Attending writes exam findings, orders labs and coordinates follow up while exam is happening

• Pertinent history/exam clarified and Attending and student briefly discuss management plan

• Attending leaves the room to finish notes/phone calls in office/conference room

• Student provides brief education to the patient and brings in the next patient and alerts the attending

• Later: student finalizes notes to send to attending for signature

Time management: Student in own room

• Faculty development and pre positioning • Students need to have the patient list the day

before to prepare for the patients • Student sees a patient while attending is

seeing another patient • Student gets a history, performs a brief exam,

does vitals, med rec, meaningful use and prepares to present

• Student gives quick summary to the attending • Pertinent history/exam clarified • Attending writes orders/scripts and then

leaves the room • Student provides education and then starts

with the next patient • Later: student finalizes notes to send to

attending for signature

Didactics and Presentations Students have didactics and presentations at home institution and have information available online We can collaborate to find out what you need the students to know (immunization schedules), and teach the students these things in their orientation. If local teaching is available- great- if not- student has access to this through BUMC Main preceptor/site director provides written midclerkship feedback to the student and a written final evaluation. Ideally there is faculty overlap and student can work with more than one preceptor.

Collaborations through Research and QI

• Students are also very interested in research and QI projects.

• Students can help with clinical research and quality improvement projects during their rotation or at any point in their medical school/residency training.

Third Year Schedule

Boston Medical Center Bournewood Hospital, Newton Children’s Hospital Boston Healthcare for the Homeless Jamaica Plain VA Mount Auburn Hospital, Cambridge Roslindale VA St. Elizabeth’s Medical Center West Roxbury VA

Beth Israel

Deaconess

Plymouth

North Shore Medical Center Beverly Hospital

Braintree Rehabilitation Hospital Brockton VA Hospital South Shore Hospital Westwood Lodge

Cape Cod Hospital

Bedford VA Emerson Hospital Lahey Clinic Lowell Community Health Lowell General Hospital Winchester Hospital

Affiliations outside of Massachusetts: Roger Williams Medical Center, Rhode Island Our Lady of Fatima Hospital, Rhode Island Central Maine Medical Center Middlesex Hospital and Middlesex Family Practice, CT

Rehoboth Seekonk Medical Center

Boston University School of Medicine Third Year Clerkship Sites 2014-2015

Beth Israel Deaconess Family Medicine Of Medfield

Beth Israel Deaconess Family Medicine Center

Boston University Affiliated Physicians, Inc.

Carmel Kelly, MD

Community Health Connection

Compass Medical

Complete Wellness

Cummings Center Medical Associates

Danvers Family Doctors

Davis Square Family Practice

Dorchester House Mulit-Service Center

East Boston NHC

East Bridgewater Family Medical

East Falmouth Family Practice

Family Medicine Associates

Family Medicine Beverly

Family Medicine North

Family Practice Group, PC

Joseph Smith CHC

Lowney Medical Associates

Manet CHC

Middlesex Family Practice

Modern Care Medical Group

Needham Wellesley Family Med PC

North Shore CHC

North Shore Physicians Group

Patton Park Medical Center

Peabody CHC

Pleasant Lake Medical

Rehoboth Seekonk Medical Center

Renaissance Family Medicine of Wellesley

Roslindate CHC

Signature Medical Group

South Boston CHC

Stephen Lane, MD

Theodor T Herwig MD PC

Trailside Health

United Family Medicine

Upham's CHC

Valley Medical Group

Waltham Family Medicine

Wellesley Family Care Associates

Affiliated Private/Group Practices and Community Health Centers