Family Practice (FMED)

FMED 816. Special Project-Family Medicine1-16 Units

Description: This course is to be arranged to fit individual needs to cover topics of current interest, to participate in research projects or to received some advanced training.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 835. Elective in Rural Medicine1 Unit

Description: Second-year elective. This elective meets 3 hours/month, mostly evenings, including an informal evening meal. The goal of this elective is to provide regular exposure to the issues of rural practice. Dr. Bill Crump and the Kentucky Academy of Family Physicians will assist with providing speakers to address common issues of rural medicine. Occasional site visits to rural practice will replace the monthly session. Topics include: practice management, time management, understanding Medicaid, working with the local school system, keeping your practice young, women's health in rural areas, working with local leaders, mental health in rural areas, when to consult and when to refer, telemedicine and working with the local health department.

Note: Method of Evaluation is paper and oral presentation.
Note: Meets 3 hrs/month throughout the academic year, except December and April.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 901. Family Medicine Clerkship7.5 Units

Description: Required third-year clerkship. This six-week family medicine clerkship will enable students to understand the principles of family medicine and their application in community practice. Four weeks of the rotation will be spent with a family physician in an approved AHEC location in Kentucky. The remaining two weeks will be spent with the UofL DFGM faculty. The student will work primarily in the outpatient setting although opportunities for inpatient care and nursing home care are a part of many of the practice sites. The students will observe the family physician's interactions with sub-specialists and use of allied health professionals. The students will gain an appreciation of different skills required to manage patients in the outpatient setting and in the context of the family unit. Small-group sessions and web-based cases will complement required readings for delivery of course content. The curriculum focuses on common problems, preventive medicine, community health, and geriat

Note: Method of Evaluation: Observation of performance, Service Learning Project, Web-based nutrition cases, clinical competency cards, standardized patient encounters and Family Medicine Subject Examination from the National Board of Medical Examiners.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 902. Acting Internship in Family Medicine4 Units

Prerequisite(s): Fourth-year standing, superior performance in core family practice.

Description: AI selective. During this four-week experience, students will assume the role of interns on the family medicine hospital service, working at University, Jewish, Norton and Kosair hospitals. The student will take in-house overnight call once a week and will make rounds on weekends and holidays following the direction of the upper level resident and attending. Students will be given responsibilities appropriate for their level of training and will have supervision by interns, upper level residents and service attendings. In general, students will be responsible for 2-4 patients at a time. Responsibilities of the student would include: initial evaluation of assigned patients including written H&P for the chart, daily rounds with hospital team, writing progress notes and orders on the charts for assigned patients, appropriate consultation and follow-up of consults, dictate discharge summaries, assist other team members in care of patients, presentation of topics relevant to assigned pa

Note: Student will be evaluated via the following methods: Faculty and residents on the service will evaluate the student on knowledge, skills and attitudes, service attending will grade the student's verbal presentation of topics and/or articles and score from a departmental exam.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 903. Senior Honors Program In Family Medicine1-8 Units

Prerequisite(s): Fourth-year standing, superior performance in core family practice.

Description: This four-to-eight week elective is intended to pair observation students with a preceptor of choice in order to complete a structured experience in community oriented primary care. The site of this elective may be local, regional, national or international. Each student will select a problem with the assistance of the program director and the preceptor, develop a project to collect data, reach a diagnosis and plan for intervention. The problem selected may be targeted at the individual patient, family, community or physician level. A presentation of the project will be expected at the conclusion of the elective at Senior Seminar. The student will develop an increased awareness of the issues involved in carrying out effective primary care prevention programs; will apply the epidemiological principles to the community oriented assessment of health status and formulate and report a plan to intervene in an identified health problem by synthesizing the data collected from interviewing a wide variety of those concerned with health care delivery.

Note: Method of Evaluation is observation of clinical performance and final presentation.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 905. Area Health Education Center-Family Medicine1-16 Units

Prerequisite(s): Fourth-year standing.

Description: This rotation must be scheduled with the clinical coordinator for Family Medicine and the AHEC Office. Arrangements should be made eight weeks before the start of the rotation with the Clinical Coordinator in Family Medicine and AHEC Office. This four-week clinical experience will be attained in various family physicians offices in designated AHEC areas of rural Kentucky. The exact nature of the rotation will vary depending on the site. Private practices, public health clinics, other ambulatory care facilities and inpatient facility experience may be included. The student will be encouraged to participate in the community to gain an understanding of how the community's characteristics affect medical care delivery. Students are expected to live in the area of the practice they select for the four-week period.

Note: Method of Evaluation: Observation of performance and submission of patient log and diagnosis seen during the rotation.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 906. Clinical Elective-Urban1-4 Units

Prerequisite(s): 4th year standing FMED 901; arrangements should be made four weeks before the start of the program.

Description: This rotation will take place in a family physicians office within Jefferson County. Experience will be gained in the outpatient and, when applicable, the inpatient setting in hospitals around the community. Attendance and participation in family practice residency conferences will be encouraged but not required. The goal of the elective is to expose the student to the field of family practice as it is practiced in an urban community. The student is expected to gain not only an understanding of the practice of family medicine but the role of the physician in the community at large. Objectives are for the student to gain an understanding of the concept of continuity of care, preventive medicine and the principles of cost effectiveness. The student must complete the Off-Campus Request Form and have it approved by the departmental course director.

Note: Method of Evaluation is observation of performance and submission of patient log and diagnoses seen during the rotation.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 907. Clinical Elective, Off-Campus1-16 Units

Prerequisite(s): Third-year standing; FMED 901; arrangements should be made four weeks before the start of the program.

Description: This is a rotation in urban family medicine to be taken outside of Jefferson County in a non-AHEC area of the state of Kentucky. This rotation will take place in a family physician office within Lexington or northern Kentucky area. Experience will be gained in the outpatient and when applicable, the inpatient setting in hospitals around the community. The goal of the rotation is to expose the student to the field of Family Medicine as it is practiced in an urban community. The student is expected to gain not only an understanding of the practice of family medicine, but the role of the physician in the community at large. The student should gain an understanding of continuity of care, preventative medicine, and the principles of cost effectiveness. The student must complete the Off-Campus Request Form and have it approved by the departmental course director.

Note: Method of Evaluation is observation of performance and submission of patient log and diagnoses seen during rotation.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 908. Clinical Elective, Outside Kentucky1-4 Units

Prerequisite(s): Fourth-ear standing; arrangements should be made four weeks before the start of the program and the student is expected to meet with FMED residency director before departure.

Description: This elective will take place within the United States but outside the Commonwealth of Kentucky and may include the other 49 states and the District of Columbia. The local preceptor should be a board certified family physician. The exact course description will vary with the site of the elective. Possible sites may include other departments of family medicine and medical schools, other community/hospital-based family practice residency programs, rotations in private physician's offices, rotations in departments of public health or another applicable rotation as arranged by the student. The student will be encouraged to participate in the community and to gain the understanding of how its characteristics affect the delivery of health care. The student must complete the Off-Campus Request Form and have it approved by the departmental course director.

Note: Method of Evaluation is observation of performance.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 910. Ambulatory Rotation-Family Medicine1-4 Units

Prerequisite(s): Fourth-year standing.

Description: AR Selective. The medical student will spend four weeks in an ambulatory clinical experience assuming the responsibility for patients in cooperation with a preceptor and participating in community activities with the preceptor. Students are expected to perform at the level of an acting intern. Supplementary instruction will include independent self-learning (assigned readings) and attending Family Practice Grand Rounds on Friday mornings at Jewish Hospital.

Note: This rotation is for a private practice ambulatory setting, not Sports Medicine; to schedule Sports Medicine, please use FMED 923.
Note: Method of Evaluation: Objective & subjective evaluation by the preceptor of knowledge, skills, attitudes of student by direct observation; pre- & post- skills assessment by the student and a patient log must be maintained and submitted to the department at the end of this rotation.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 912. Geriatric Medicine2-4 Units

Prerequisite(s): Third-year standing, FMED 901; this elective must be scheduled with the clinical coordinator for Family Medicine.

Description: This two-to-four-week elective is designed to provide the medical student with an in-depth exposure to comprehensive care for the geriatric patient. The rotation focuses on evaluation and management of the medical & psychosocial aspects of aging. It exposes the student to different environments of caring for the geriatric patient, from nursing homes and home visits to outpatient clinic visits. Students will gain an understanding of routine medical management of the geriatric patient in the outpatient setting, preventative care, geriatric syndromes and management, care of the hospitalized patient, and palliative care.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 917. School Health2 Units

Prerequisite(s): Fourth-year standing; this elective must be scheduled with the clinical coordinator for Family Medicine and student must meet with faculty four weeks before rotation begins for discussion.

Description: This is a two-week elective. Schools are a major institution that can influence the health and well being of youth. Experience will be gained by assisting school staff in the health needs of students; observing children with behavioral disorders, learning disorders and physical disabilities; interacting with students and teachers in classroom situations; and working with school resource centers. The goals of this rotation are to increase the understanding of the role of physicians in schools, gain knowledge of how schools function and the role of the schools in family and community health. Students will be able to identify medical problems and issues in school health; present age appropriate health information; recognize children with medical conditions that may inhibit learning; and examine community resources to assist school age children. Students must submit a journal detailing their experiences.

Note: Method of Evaluation includes observation of performance and evaluation of student's journal; the evaluation completed by the school personnel and students will account for part of the evaluation.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 918. Introduction to Medical Informatics1-4 Units

Grading Basis: Pass/Fail

Prerequisite(s): Fourth-year standing; this elective must be scheduled through the clinical coordinator in Family Medicine.

Description: In this four-week elective, the student will have the opportunity to: Acquire and demonstrate basic computer skills, or expand existing skills; experience or investigate a broad range of topics in the realm of medical informatics; complete a defined set of projects related to areas of special interest; and define possible future involvement in the area of medical informatics. Proposed topics to include: Office Systems, Computer Systems & Technology, Web Applications, Expert Systems, Decision Science, Hospital Systems, Structured Language Research, Information Search, Retrieval and Management, Standards Systems and Organizations, Medical Informatics Community, Medical Education, Telemedicine and Telecommunications and Basic Computer Skills and Usage.

Note: Method of Evaluation is subjective grade based on the student's displayed initiative, interest, and completion of individual objectives as defined with the faculty mentor.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 922. Community Clinic1-4 Units

Prerequisite(s): Third-year standing.

Description: This two-, three-, or four-week rotation will take place in a free clinic within Hopkins County. Experience will be gained in the outpatient setting caring for the low-income working uninsured. The student will be exposed to issues involved with free clinic care including administrative issues of negotiation for lab, imaging and consults; practicalities of current pharmaceutical assistance programs; clinical issues of providing comprehensive care in this environment; and use of an electronic medical record in this setting.

Note: Method of Evaluation is observation of performance.
Note: This elective located at the Trover campus, Madisonville, Kentucky, and must be scheduled through the Trover Office.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 923. Sports Medicine1-4 Units

Prerequisite(s): Fourth-year standing.

Description: This four-week clinical elective is for students interested in sports and sports related care. Students will work with the sports medicine faculty at the Owsley Brown Frazier Sports Medicine Center seeing patients with sports related injuries. There will also be exposure to athletic training facilities where the faculty physicians care for collegiate athletes. Depending on the time of year, the students may participate in event coverage.

Note: Method of Evaluation is observation of performance.

Course Attribute(s): CBL - This course includes Community-Based Learning (CBL). Students will engage in a community experience or project with an external partner in order to enhance understanding and application of academic content.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 924. Medical Jurisprudence-Introduction to Health Law2 Units

Grading Basis: Pass/Fail

Description: Second-year elective. This course is an examination of medical jurisprudence: the law, legal system and legal reasoning related to medicine. This introduction to health law undertakes a survey of legal issues in medicine focusing on the four ultimate health care system concerns: quality, autonomy, or personhood; equitable access and cost. Coverage includes: (a) introduction to law, the legal system and legal reasoning; (b) quality control regulation through licensing of health care professionals; (c) the physician-patient relationship, informed consent and confidentially; (d) professional liability and reforming the tort system for medical injuries; (e) cost and access to health care in the health care delivery system; (f) professional relationships in health care enterprises, staff privileges, managed care contracts, labor & employment, & discrimination law; (g) Medicare & Medicaid fraud and abuse, false claims & Start law self-referrals; (h) reproduction and birth, legal status of the embryo/fetus, medical intervention in reproduction, and fetal maternal decision-making; (i) legal issues in human genetics; and (j) life and death decisions, advance directives, withholding/withdrawing life support, treatment refusal for religious reasons, decisional capacity and guardianship, deciding for children, futile treatment.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 925. Rural Practice Assessment4 Units

Description: Required course for the RMAT program only. This rotation is focused on a detailed analysis of a rural physician's practice with an emphasis on continuity of care. The vehicle for the needed clinical learning portion will be the chronic care note, which is currently used in the third-year Family Medicine Clerkship. The RMAT student will: 1) with a physician's guidance, choose a common condition see in practice, e.g., hypertension, dyslipidemia, diabetes, 2) develop a protocol for management based on published guidelines, 3) complete the chronic care notes on patient visits that occurred during their rotation, including the student's telephone call or home visit follow-up some time after the index visit, and 4) prepare original patient education materials for the chronic condition suitable for continuing use in the practice, including a checklist shared by the patient and the provider that lists the key milestones of management. Goals & Objectives To teach the student clinical skills through observation and practice; to have the student become familiar with the types of clinical problems managed in rural primary care; to have the student become familiar with the process of individual practice site assessment by interviewing key personnel in the practice; to have the student understand important aspects of continuity of acre by studying a series of visits by patients with a common illness; and to have the student understand how clinical guideline can drive the development of patient education materials.

Note: Method of Evaluation will include assessment by the preceptor, assessment of the chronic care notes, practice assessment report and the patient education materials.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 926. Rural Community Health Assessment4 Units

Description: Required course for the RMAT program only. This rotation is focused on patient education, community assessment, anticipatory guidance for children, and physical examination skills. Students will complete this component as part of the Trover Preclinical program during July of their second year. This four-week block includes a community-driven project that provides free school physicals (required in Kentucky) to 6th-grade students in two Heath Professional Shortage Area (HPSA) counties near Madisonville, the home of the Trover Campus. This activity is referred as PSST. The guidance materials and teaching props will be produced by the RMAT students working with the Pre-Med Trover Rural Scholars. The RMAT students will complete the physical examinations under the supervision of certified Health Department nurses and the Associate Dean for the Trover Campus. Past Trover Scholars and preclinical student have jointly prepared and presented a final report summarizing their findings from the examinations as well as the results of a county-wide community assessment. Goals & Objectives are 1) To reinforce the development of clinical skills through observation and practice; 2) To have the students understand the details of the clinical decision-making process used in rural primary care; 3) To have the students become familiar with the process of community health needs assessment by participating in a county-wide assessment; and 4) To have the students obtain hands-on experience, under appropriate medical supervision, in administering screening physical examinations and anticipatory guidance in rural community clinics.

Note: Method of Evaluation includes paper assessment by the preceptor, evaluation of small group participation and performance during PSST, oral presentation of the report, and an assessment of the written report; feedback is received from the nurses participating in PSST, both on individual student performance and in a group debriefing at the conclusion of each PSST session.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 927. Rural Practice Clerkship4 Units

Description: RMAT program only. This is the third component of the RMAT and is a four-week experience in Family Medicine that encompasses 5 of the 8 goals of the existing third-year family medicine clerkship. This rotation is in a rural community practice. At the end of the rotation, students will be able to discuss the principles of family medicine; gather information, formulate differential diagnosis and propose plans for the initial evaluation & management of patients with common presentations; develop evidence-based health promotion/disease prevention plans for patients of any age or gender; demonstrate competency in advanced elicitation of history, communication, physical exam and critical thinking skills; utilize appropriate techniques to communicate with patients of all levels of health literacy.

Note: Method of Evaluation includes standard clinical evaluation form and the NBME examination.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 928. Longitudinal Ambulatory Experience4 Units

Description: RMAT program only. This is the fourth component of the RMAT and is a required four-week experience in the free clinic for working, low-income, uninsured families of Hopkins and Webster counties in Kentucky. Three of the eight goals of the existing family medicine clerkship are encompassed in this rotation and focuses on longitudinal continuity of outpatient care within a matrix of performance improvement concepts, using a simple electronic health record, chart review, staff interviews, protocol development and new patient intake clinics and evening experiences in treating patients in a continuity clinic.

Note: Method of Evaluation includes standard clinical evaluation form and student's final report of a performance improvement project.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 929. Rural Family Medicine-Acting Internship4 Units

Description: RMAT program only. This is the final component of the RMAT and is a required six-week experience. Student will be working with the upper-level residents and hospital attending and will assume responsibility for daily patient care of assigned patients, including the ICU. The student will outline the evaluation and management of common inpatient problems in family medicine and will demonstrate the ability to work with all team members including ancillary services and consultants.

Note: Method of Evaluation includes standard clinical evaluation by Family Medicine faculty and a departmental exam.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 930. Medical Spanish2 Units

Prerequisite(s): Fourth-year standing; completion of at least one (1) year of Spanish beyond high school.

Description: ELECTIVE NO LONGER AVAILABLE This two-week elective is designed to provide the medical student with an opportunity to acquire skills necessary to interview Spanish speaking patients. The elective focuses on communication skills and professional behavior. Through didactic sessions, direct observation and interactive group meetings, students will learn medical terminology and acquire skills in medical interviewing. Summative evaluation will include conducting a complete interview in Spanish.

Note: Method of Evaluation includes observation of participation by faculty and student instructors and assessment of student's completion of all assigned tasks.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 932. Family Nutrition Resources1 Unit

Prerequisite(s): Fourth-year standing.

Description: This one-week elective is designed to provide the medical student with an opportunity to acquire skills necessary to assess patients' nutritional status and offer suggestion for intervention that will improve the overall health of the patient and family. The rotation focuses on independent study, observation, reflective writing, and professional behavior. Through self-study, direct observation, and planning of an outreach event, students will gain knowledge in nutritional topics and acquire skills in methods of intervention to improve the nutritional status of the patients. Summative evaluation will include faculty evaluation of the student's completed assignments.

Note: Not currently available; this elective was only offered 9/18-9/22/17 and 3/25-3/31/18.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 933. Sexual Health SP Encounters1 Unit

Grading Basis: Pass/Fail

Term Typically Offered: Fall, Spring, Summer

Prerequisite(s): First-, third-, or fourth-year medical student.

Description: This elective is aimed to create the optimal learning environment for students to practice taking sexual histories, while addressing concerns around sexual dysfunctions/abnormalities, educating on best sexual health practices, and providing a safe space to discuss sexual trauma and normal reproductive health.

For class offerings for a specific term, refer to the Schedule of Classes

FMED 934. Family Medicine Bootcamp2 Units

Grading Basis: Pass/Fail

Term Typically Offered: Spring Only

Description: This course is designed as preparation for intern year-two weeks of practical skills and knowledge that will help graduating medical students who have matched into Family Medicine hit the ground running as interns. It will be a mix of didactic sessions, procedure workshops, interactive case-based learning, and Q&A sessions with residents and faculty. We will cover typical medical issues that will be encountered in both inpatient and outpatient settings - headache, chest pain, congestive heart failure, kidney failure, musculoskeletal complaints, etc. All of these will be approached from a high-yield, practical information perspective. We will also cover basics in quality improvement, evidence-based medicine and information mastery, and mindfulness and self-care. We will also do procedure workshops on suturing, splinting, and joint injections.

Note: This elective will only be offered 4/10-4/21/23.

For class offerings for a specific term, refer to the Schedule of Classes