STEPS FOR PROCURING A FAMILY MEDICINE ELECTIVE
Step One: Arrangement and Approval from the Course Director
All students MUST get initial approval from the official elective course director or contact person.
Please note the follow policies:
**All students attending a medical school outside of the US or from a medical school which is not LCME accredited MUST contact Ms. Melanie Woods, Assistant Registrar, Einstein Office of the Registrar at melanie.woods@einstein.yu.edu or 718-430-2102.
**Rotations may occasionally be unavailable due to conflicting Faculty responsibilities. Always confirm availability and where to report on the first day of the rotation with the sponsoring Faculty.
**The student must commit to a minimum of 4 weeks in duration (see FM524 ECHO Free Clinic for detailed commitments).
**Fourth year students can take up to 3 days off to interview for residency programs with advanced approval of the course director.
**Unofficial electives and preceptorships are strongly discouraged and will not be approved.
**Students who are interested in the FM815 elective at Beth Israel should contact Marvia Alston directly at (212) 420-2058. All students who are interested in FM823 Beth Israel should contact Dr. Linda Prine directly at (917) 920-2855, or email lindaprine@mac.com. Visiting students do not need to follow the rest of the steps below as Beth Israel has their own application process.
**Visiting students who are interested in electives at Jamaica Hospital Family Medicine Residency Program should contact Shelly Padgett at (718) 206-6919 or email spadgett@jhmc.org and do not need to follow the rest of the steps below.
For any further questions regarding elective choices at Einstein/DFSM, please contact:
Ms. Adrianna Nieto
718-430-2900
adriana.nieto@einstein.yu.edu
Step Two: Finalize with Department of Family and Social Medicine
The student and course director MUST contact our Department of Family and Social Medicine (DFSM), Medical Student Education Office via Adriana Nieto at or 718-430-2900 to confirm mutual approval.
Step Three: Final Approval and Registration with the Office of Registrar
Visiting and Osteopathic students should view the Visiting Student website for detailed application requirements and instruction as to how and when to apply for electives. All paperwork and fee requirements must be satisfied before final approval is granted by the Office of the Registrar.
All students from Einstein, LCME-accredited medical schools and osteopathic medical schools may apply for certain electives listed below. Once the student has satisfied all DFSM requirements, the DFSM will notify the Office of the Registrar. The Office of the Registrar will register students accordingly.Please check with Ms. Melanie Woods, Assistant Registrar, Melanie.Woods@einstein.yu.edu, for more information regarding registration and final approval.
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The following electives are offered by the faculty of the Department of Family and Social Medicine at Montefiore Medical Center and it's Family Practice Residency in the Montefiore Residency Program in Social Medicine (Bronx, NY): Beth Israel Family medicine Residency program (Manhattan, NY), Jamaica Hospital Family Medicine Residency Program (Jamaica, Queens), and Bronx Lebanon Medical Center (Bronx, NY). Electives are available in the following categories:
ADOLESCENT MEDICINE
FM503 School-Based Health Care (Montefiore)
FM507 Adolescent Health Care in a Family & Community Context (Montefiore)
AMBULATORY FAMILY MEDICINE
FM509 Advanced Ambulatory Family Medicine (Montefiore Residency Program)
FM815 Urban Family Medicine (Beth Israel Family Medicine Residency Program)
FM901 Urban Family Medicine (Jamaica Hospital Medical Center)
FM910 Advanced Ambulatory Family Medicine (Mid-Hudson Family Practice Residency Program)
BEHAVIORAL SCIENCES
FM504 Family, Systems and Health (Montefiore)
FM526 Understanding the Spiritual and Religious Dimension of Patients (Montefiore)
COMMUNITY AND CULTURAL MEDICINE
FM508 The Health and Healthcare Needs of Lesbian/Gay/Bisexual/Transgender Community (Montefiore)
FM517 Culture and Care (Montefiore)
FM530 Medical Spanish Immersion in the Bronx (Einstein/ Institute for Family Health)
COMPLEMENTARY MEDICINE
FM505 Complementary Therapies and Alternative Healing (Montefiore)
GLOBAL HEALTH
FM529 Global Health in Guatemala (Montefiore)
HEALTH CARE SYSTEMS
FM524 ECHO Free Clinic Longitudinal Outreach (Einstein)
INPATIENT FAMILY MEDICINE
FM510 Family Medicine Inpatient Service (Montefiore Residency Program)
FM810 Family Medicine Inpatient Service (Beth Israel Residency Program)
PALLIATIVE CARE
FM527 Palliative Medicine Consultation Service (Bronx Lebanon)
FM528 Palliative Care (Montefiore)
FM900 Palliative Care (Jamaica Hospital Medical Center)
RESEARCH IN FAMILY MEDICINE
FM521 Family Medicine Research (Einstein / Montefiore)
SOCIAL MEDICINE
FM520 Research-Based Health Activism (Montefiore)
WOMEN'S HEALTH
FM501 Reproductive Health (Montefiore)
FM823 Women's Reproductive Health (Beth Israel)
WOUND HEALING
FM506 Preceptorship in Wound Healing (Montefiore)
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FM501 Reproductive Health (Montefiore Medical Center)
Students will participate in clinical sessions at Family Health Center and Williamsbridge to learn about the integration of full spectrum women's health into routine family medicine. Objectives: Tailored to needs, interests, and experience of each student. Learning Experience: The month will be composed of clinical care with supervision, reading relevant articles, and reflection on experience/learning after each clinical session.
Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Evaluation will be based on direct experience in the clinic.
Dr. Marji Gold
718-920-2885
Marji.gold@einstein.yu.edu
Module:All
Maximum: 2
FM503 School-Based Health Care (Montefiore Medical Center)
The Montefiore School Health Program is offering a full time, four week clinical elective for fourth year medical students on School-Based Health Care (SBHC). Students will engage in clinical encounters with school age patients at elementary, middle and/or high school based health centers under the direct supervision of experienced preceptors, including pediatricians, family physicians and nurse practitioners. Students will experience an interdisciplinary approach to patient care through individualized workshops with mental health providers on a selection of relevant topics and participation in an ongoing community health project.
Ms. Margee Rogers, DNP
718-696-4069
mrogers@montefiore.org
Modules: Only offered October, November, March and May
Maximum: 1
FM504 Family, Systems and Health (Montefiore Medical Center)
This elective will focus on family and systemic factors influencing health and the doctor-patient relationship. Topics addressed include somatization, chronic and terminal illness in addition to common behavioral health issues presented in primary care. Objectives: Students will be able to describe typical behavioral and psychosocial approaches to medical problems in primary care. Students will be able to examine the role of family and social relationships in health. Students will be able to identify common systemic health care related factors which affect the health of patients from disadvantaged backgrounds. Learning Experience: Students will be able to interview patients and observe faculty during patient care sessions. Individual tutorials, readings and attendance to didactic sessions are also available. The elective is tailored to the interests and needs of the student. Feedback & Evaluation: Students receive formal feedback midway and at the end of the rotation. Verbal evaluation plus questionnaire. Location: The DFSM office at 3544 Jerome Ave Bronx NY 10463. Clinical sessions will be at the Family Health Center, 360 E 193d Street.
Ms. Eliana Korin, Dipl. Psych.
718-920-2821
ekorin@montefiore.org
Modules: All except June, July, August, September & October
Maximum: 1
FM505 Complementary Therapies and Alternative Healing (Montefiore Medical Center)
This elective will provide the student with an introduction to the philosophy of integrative medicine and a supervised exposure to complementary therapies and alternative healing methods in primary care settings (e.g. community health center and small practice). Among the therapies to be covered are meditation, relaxation techniques, acupuncture, acupressure, biofeedback, shiatsu massage, chiropractic, energy and herbal medicine. Objectives: Examine the philosophies of integrative medicine. Analyze how these philosophies differ from Western conventional medicine. Identify areas of complementary and alternative medicine (CAM) to address more deeply. Explore these areas through reading and observation. Examine the evidence base for these CAM approaches. Reflect on the place of CAM approaches for self and future patients. Describe the integration of CAM approaches in future patient care. Learning Experience: Students will read and discuss introductions to integrative medicine philosophies and techniques. Students will rotate with practitioners of many different healing modalities depending on their interest. Students will meet with the course director throughout the clerkship to review what they have observed and reflect on its place in their own self-care and the future care of their patients. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Evaluation is based on the student's motivation and initiative as well as their grasp of similarities and differences among a number of different healing systems and modalities. Evaluation is also based on the student's depth of reflection on the place of integrative medicine in their future care. Location: Students will contact me to schedule the first meeting. The elective places students with practitioners throughout the city depending on their interest.
Dr. Ellen Tattelman
718-920-4678
etattelm@montefiore.org
Modules: Variable. Please call ahead.
Maximum: 1
FM506 Preceptorship in Wound Healing (Montefiore Medical Center)
Chronic wounds, such as diabetic foot ulcers, venous stasis ulcers, and pressure ulcers, are highly prevalent in chronically ill and elderly patients. They represent a significant public health burden and cause untold morbidity, disability, and mortality. In this elective, students will learn how to evaluate patients with chronic wounds; diagnose underlying factors that lead to physiologically impaired healing; formulate evidence-based treatment plans including topical, medical, surgical, and biologic treatment modalities; apply basic techniques of wound debridement; recognize secondary complications of wounds; and prevent wound recurrence. In addition, students will gain experience in optimizing patient safety during surgical management of patients with complex co-morbid disease. Upon completion of this elective, student will have the skills to become leaders in saving lives and limbs for patients with chronic wounds. This course is highly relevant to students entering a variety of career paths, including but not limited to family medicine, internal medicine, surgery, plastic surgery, geriatrics, rehabilitation medicine, endocrinology, and infectious disease. Students are strongly encouraged to participate in ongoing research in addition to their clinical work. The elective can be tailored to students’ specific interests, in discussion with the instructor. Objectives: Evaluate patients with chronic wounds. Diagnose underlying factors that lead to physiological impaired healing. Formulate evidence-based treatment plans including topical, medical, surgical, and biologic treatment modalities. Apply basic techniques of wound debridement. Recognize secondary complications of wounds. Prevent wound recurrence. Understand health systems needs for wound patients. Learning Experience: Active participation in the inpatient Wound Healing consultation service. Outpatient care of patients with chronic wounds. Weekly nursing home Wound Rounds. Visits can be arranged to related services, e.g. Foot & Shoe clinic, hyperbaric medicine, home visits. Feedback & Evaluation: Students will receive formal feedback midway after each week. The evaluation is compiled by the supervising physician. Location: Students will report to Dr. Anna Flattau. The core schedule will include daily inpatient rounds, participation in bedside debridement, outpatient would clinic 1-2 times per week, and nursing home rounds once per week.
Dr. Anna Flattau
718-920-4678
annaflattau@yahoo.com
Modules:All
Maximum: 1
FM507 Adolescent Health Care in a Family & Community Context (Montefiore Medical Center)
This elective will examine the care of adolescents from a family and community perspective. Adolescence as an individual and developmental phase as well as its influence on the family life cycle will be explored through readings and patient care encounters. The student will have the opportunity to work with adolescents and their families in family-focused, school-based, and street-outreach settings and be engaged in discussion and analysis if common adolescent health issues such as violence, suicide, sexuality and family dynamics will occur with a focus on health maintenance and prevention. Objectives: To review principles of adolescent physical, cognitive and psychosocial development. To improve confidence and competence in interviewing adolescents. To experience adolescent health care in the context of multidisciplinary teams. To explore in detail and write about a topic of interest in the field of adolescent medicine. Learning Experience: Students will spend the month thinking adolescence - through clinical and non-clinical readings, films and discussions with adolescents in their own family and social networks. They will spend several days/week interviewing and caring for adolescents in the context of high school based health centers. They will have an opportunity to experience care of homeless adolescents and understand the special issues facing LGBT teens. Students will continue to develop their literature review and writing skills through preparation of a three-page paper addressing a topic of their interest. Location: Students will meet with Dr. Victoria Gorski on or about the first day of the elective at 3544 Jerome Ave to discuss an overview of the month, set personal learning goals and receive required readings. They will meet on or about the first day of the elective with Margee Rogers, FNP and coordinator of the school-based portion of the elective. Her office is located at 3380 Reservoir Oval. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Dr. Victoria Gorski compiles and summarizes feedback from the clinical supervisors who interact with the students and completes the evaluation form.
Dr. Victoria Gorski
718-920-4678
vgorski@montefiore.org
Modules: only offered October, November, March, May
Maximum: 1 student
FM508 The Health and Healthcare Needs of Lesbian/Gay/Bisexual/Transgender Community
This elective will examine the health and healthcare needs of the lesbian/gay/bisexual/transgender (LGBT) patients through readings, patient encounters and community based experience. Available areas of study include life cycle, bias, violence, identity, health promotion, prevention and clinical practice. Objectives: At the end of the elective, students will be able to: Identify the healthcare needs of LGBT patients. List the challenges faced by LGBT patients in accessing care. Identify ways to overcome these challenges. Identify Bronx resources for LGBT patients. Learning Experience: There will be opportunity to work with community based organizations such as the Bronx Community Pride Center (www.bronxpride.org) and clinical experience with providers interested in providing care for this diverse community. Location: South Bronx Health Center for children and Families, Dr. Peter Meacher, Bronx Community Pride Center, Dr. Robert Beil & Lisa Winters (Executive Director).
Dr. Peter Meacher
718-991-0605, pmeacher@montefiore.org
Dr. Robert Beil
718-579-2500, rbeil@montefiore.org
Module: All
Maximum: 1
FM509 Advanced Ambulatory Family Medicine (Montefiore Medical Center)
Fourth year medical students with a dedicated interest in a career in Family Medicine, and service to underserved communities, will have the opportunity to work in urban ambulatory care settings affiliated with the Department of Family and Social Medicine (DFSM) and the Family Medicine Residency Program. Objectives: Enhance their level of competence in prevention, diagnosis and treatment of common ambulatory problems. Integrate bio-psychosocial approaches in their care of patients and families. Explore aspects of culturally-responsive care, the Patient-centered Medical Home, community-oriented primary care, and social medicine. Learning Experience: Students will be directly involved in the evaluation and treatment of ambulatory patients in patient care sites affiliated with Montefiore Medical Center, including the DSFM Family Medicine residency program. The student will gain broad medical experiences serving diverse urban communities. Students will work under the supervision of Family Medicine faculty, and will be expected to independently evaluate patients and formulate treatment and follow-up plans for review with their preceptors. Students will attend all educational conferences, tour community agencies of the Bronx, and will have opportunities to attend inpatient rounds of the Family Medicine service, participate in palliative care home visits and precept cases with behavioral sciences faculty. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. The course directors will compile a final evaluation based upon the evaluations by all preceptors. Location: Family Health Center and Williamsbridge Clinics of Montefiore, home visits with Metropolitan Jewish Home Care, and various other community partner settings.
Dr. William Jordan
Director of Medical Student Education
718-430-2900, wjordan@montefiore.org
Dr. Lisa Baron
Associate Residency Director
lbaron@montefiore.org
Dr. Andrea Ritchin
Medical Student Site Director - Family Health Center
aritchin@montefiore.org
Dr. Mark Polisar
Medical Student Site Director - Williamsbridge Family Medicine
mpolisar@montefiore.org
Modules: All, except August
Maximum: 1
FM510 Family Medicine Inpatient Service (Montefiore Medical Center)
The sub-internship is a four to eight week rotation on the Family medicine inpatient unit at Montefiore Hospital. Students will work with an interdisciplinary team to provide family centered care to adult inpatients. There will be opportunities to attend core Family Practice and social medicine curriculum activities in the department. Objectives: Foster an understanding of the family physician's role in hospital management of patients. Develop clinical decision making and problem solving skills, and the ability to exercise judgment about the appropriate level and options for care. Develop self-directed learning skills essential for life-long learning in the field of medicine. Understand the psychosocial impact of illness in families of different cultures and socioeconomic backgrounds. Learning Experience: Students will work with the team (which also includes nurses, social workers and a clinical pharmacist) to care for patients from the department’s health centers, as well as from the emergency department. Students will have the opportunity to work up admissions, place orders, present patients on rounds, perform procedures and discuss management with consultants. In addition, they will participate in the team's call schedule. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Teaching attending physicians contribute to the final evaluation. Location: Most work will be done on Northwest 7, the Family Medicine inpatient unit, at Montefiore Hospital. The health care team consists of an attending, 3 residents (two day, and one night float) and four interns (three day, and one night float).
Dr. Purnima Garg
STUDENT MUST CONTACT SUB-INTERNSHIP COORDINATOR:
Dr. Maria Santos
718-430-2900
Maria.Santos@einstein.yu.edu
Modules: All except July
Maximum: 2
FM517 Culture and Care
This elective will address the complexities of providing medical care to patients from diverse socio-cultural backgrounds. Students will have the opportunity to see patients at a community health clinic to examine medical problems in relation to particular socio-cultural determinants. They will learn about health beliefs and practices among diverse socio-cultural groups, immigrant health issues and their impact to the doctor-patient relationship and health care in general. Objectives: Formulate medical problems within a socio-cultural framework. Examine typical clinical problems in relation to social determinants of health. Integrate a socio-cultural perspective into the medical interview. Describe common challenges faced by immigrants and their impact on health and health care. Learning Experience: Interview with patients, and observations of faculty interactions with patients; readings, videotape reviews and tutorials. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Teaching faculty contribute to the final evaluation. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Combined assessment of all elective leaders. Location: Residency Program in Social Family medicine, Jerome Ave. and the Family Health Center Clinic.
Eliana Korin, Dipl. Psych.
718- 920-4678
ekorin@montefiore.org
Modules: All except September and October
Maximum: 1
FM520 Research-Based Health Activism
Students who are interested in conducting primary care research, health services research or epidemiology of urban populations may arrange to work with a faculty member of the DFSM research division. Students will be matched to a faculty supervisor whose research area and expertise matches the student's interest and goals. The course director can assist students with housing. Objectives: Be able to define the concept of "Research based health Activism". Be comfortable in describing the organization of the US health system and current policy priorities. Be proficient in developing research questions that can be evaluated in quantifiable ways. Be able to describe the strengths and weaknesses of different study designs for epidemiologic research. Be able to develop an advocacy plan for making use of research findings to influence public policy, including determining short term, intermediate, and long term goals and identifying appropriate targets, allies, and opposition. List characteristics of effective advocacy organizations and skills necessary for coalition building. Increase their comfort and skills in public speaking. Demonstrate proficiency in media relations. Prepare and present a project proposal, including background information, research question, methodology and advocacy plan that addresses a health care issue of their choice. Will have opportunity to complete their research project and submit findings for publication or presentation at a national meeting. Learning Experience: The month will be composed of three major curriculum segments to aid in developing their project proposal. The first segment is background on US health policy and politics. the second segment is epidemiology and biostatistics in order to develop the skills needed to create credible data that will have an impact. Finally, the segment on advocacy skills will give students the tools they need to make use of their findings effectively. Students will participate in hands on learning about media relations, coalition building, and public speaking. Learning experiences will also include talks given by nationally renowned policy experts, interactive seminars with physician and non-physician activists, journal clubs and discussion groups, site visits to advocacy organizations, and direct advocacy experiences such as media contracts or lobbying elected officials. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Evaluation will be based on attendance, effort during seminars, completion of weekly assignments, and completion of final project proposal. Location: 3rd Floor Conference room, Department of Family and Social Medicine, Jerome Avenue, Montefiore Medical Center.
Dr. Aaron Fox
718-920-2990 or 718-579-2500
adfox@montefiore.org
Module: 3A only
Maximum: 10 students
FM521 Family Medicine Research
Students who are interested in conducting primary care research, health services research or epidemiology of urban populations may arrange to work with a faculty member of the DFSM research division. Students will be matched to a faculty supervisor whose research area and expertise matches the student's interest and goals. Objectives: Students will identify a topic and specific learning objectives with the faculty supervisor at the beginning of the elective. Students will acquire skills in some or all of the following areas, depending on experience and scope of project: literature synthesis, study design, data collection, data analysis, and writing for publication. All students will acquire a basic understanding of human subjects concerns as they relate to their project. Learning Experience: Specific learning experiences will vary with the project selected. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. The course director will complete the final evaluation. Location: DFSM Research Division and community sites depending on specific project.
Dr. Diane McKee and colleagues
718-430-2154 or 718-430-2750
diane.mckee@einstein.yu.edu
Modules: All
Maximum: Number of students per month varies depending on interest and project.
FM524 ECHO Free Clinic Longitudinal Outreach
**NOT OFFERED TO VISITING STUDENTS**
The Walton Family Practice Einstein Community Health Outreach ("ECHO") Free Clinic provides free health care for uninsured adults in the South Bronx, a medically underserved area (MUA). The clinic sees about 30 patients each session, offering primary care services such as physical examinations, women's health, prescription medications, laboratory tests, health education, and social services. This longitudinal elective trains senior medical students in ambulatory care management so that they may become ECHO Clinic Session Coordinators, working with faculty physician and nurse practitioner preceptors, MS-III Family Medicine clerks, pre-clinical volunteers, and ancillary staff to provide free care and social service referrals to those in need. In addition, this elective provides students with research opportunities regarding the challenges of delivering primary care at a community-based health center in a medically underserved area. Learning objectives: Recognize the importance of continuity and quality primary care by demonstrating effective communication skills from session to session. Gain insight into the challenges of serving diverse urban communities. Manage a primary health care team effectively and contribute to the team goal of assuring quality patient care in the outpatient clinic setting through initial patient visits, follow-up visits, and proper referrals. Refine clinical skills in triage and patient-flow management in a busy family practice. Develop leadership and educational skills by managing and teaching a team of pre-medical, MS-I, MS-II, and MS-III volunteers. Organize interdisciplinary collaboration with social workers, nurses and other ancillary staff to provide quality patient care. Develop and demonstrate facility with the EPIC Electronic Medical Record in an ambulatory setting. Demonstrate knowledge of the system of public and private insurance and innovations in health delivery that pertain to uninsured adults. Demonstrate comprehension of issues involved in urban health care and the capacities and limitations of the free clinic model. Investigate a topic of interest in health care for multicultural populations, health care disparities, or health care delivery and demonstrate expertise by preparing findings in a written paper. Learning experience: For the clinical part of the elective, the student will work as session coordinator for 10 sessions. As Session Coordinators (SCs), students are responsible for the administration and scheduling of volunteers at the clinic for that week under the supervision of the attending physicians and Medical Director (Dr. Cortijo). A typical week consists of pre-, during-, and post-session tasks. Pre-session duties begin early in the week and involve planning, organizing, and educating the pre-clinical volunteers and Family Medicine clerks. At the beginning of every clinic session, the SC gives a didactic orientation to the volunteers of the day, focusing on the role of each volunteer, how the clinic operates, and how to use and manage the electronic medical record (EMR). Then the SC facilitates patient triage and/or flow. The Triage SC focuses on seeing walk-in patients, assessing their chief complaints, and assigning them to the respective clinical teams for evaluation and care. Working in this position is an excellent means of honing clinical skills and judgment, as it requires experience and knowledge about what can be done in brief patient encounters and how to optimize the use of the other volunteers at the clinic. This student may triage and write “SOAP” (i.e., Subjective, Objective, Assessment, Plan) clinical notes on more than 15 patients in a given clinic session. The Flow SC works closely with the six clinical teams (comprised of Family Medicine clerks and the pre-clinical shadowing students), assigning patients, providing clinical advice, and using the EMR. During the session, all of the SCs are also responsible for assisting the MS-III clerks with phlebotomy, in-house labs, and injections. Weekly during-session tasks also include reviewing laboratory and referral results with the preceptors and arranging follow-up care. For the post-session tasks, the SCs will write a post-session summary, reflecting on the clinic experience, the performances of every volunteer, any issues or problems encountered during the session, and suggested areas for improvement of patient care and follow-up. Additionally, the SCs will communicate with the SCs in charge of the next session, to ensure continuity of care for the patients of their respective session. At the end of the elective, the student will be required to arrange a portfolio of their session summaries and/or SOAP notes. The students will be responsible for finishing the clinical component of the elective (10 sessions at the ECHO Clinic) prior to a one-month reading tutorial under the guidance of Dr. Hal Strelnick during module 6A. The reading tutorial component will enhance students' understanding of their work in the broader context of the health care system. The month will be divided into two weeks of discussions and seminars led by Dr. Strelnick, as well as two weeks of reading time and research for a capstone paper. Capstone topics will depend upon the student’s interest, but may include the development of public and private insurance, innovations in the public and private delivery health services, issues in health manpower, health care regulation, comparative health systems, health planning, and socio-cultural impacts upon health and diseases. Students will further investigate a topic of interest in these domains as informed by their experiences working in the free clinic and will produce a written discussion of their findings.
ECHO Free Clinic Longitudinal Outreach = 10 Clinical Sessions (Session Coordinators) & 4 Weeks Research Reading Elective (2 Weeks Discussion/Seminars & 2 Weeks Paper/Research Time)
Method of student feedback and evaluation: Overall, students will be evaluated in two parts. Dr. Strelnick will be evaluating the reading tutorial and paper completed by the student. Dr. Cortijo will evaluate from direct observation and from feedback provided from ECHO clinic faculty attending physicians and nurse practitioners. She will also be in charge of putting together the final course grade based on the student’s average of their tutorial, research, and clinical evaluations. Mid-way evaluations, discussing professional strengths and areas of improvement, will be performed by Dr. Cortijo after the student has completed ten clinic sessions as SC. In addition, students will receive frequent feedback after each session by the clinic chairs and attending physicians regarding the students’ clinical, leadership, and communication skills. Location: On the first day day students should report to: 1894 Walton Ave, Bronx, NY 10463 in the Walton Family Practice Center
Dr. Amarilys Cortijo
718-583-9000
acortijo@institute2000.org
Dr. Hal Strelnick
hstrelni@montefiore.org
Modules: 5B and 6A
Maximum: 10
FM526 Understanding the Spiritual and Religious Dimension of Patients
This elective course explores spirituality and religion as it impacts patient's health and care management. A combination of clinical experiences and classroom seminars are provided to build knowledge, skills and potential change in attitude surrounding the importance of this patient dimension. Students are encouraged to reflect on their own religious and spiritual selves as it impacts the doctor-patient relationship and sustains the practice of humanistic medicine. Objectives: Develop a respect for and collaborative relationship with clergy and other spiritual leaders as members of an inter-professional team. Understand that spirituality and religion provides a view of life for some patients that gives hope, meaning and a sense of security during health, illness, pain and suffering and at the end of life. Learn the communication skills to address spirituality and religion with patients that respect their beliefs and values regarding health and health care management. Explore and reflect on one's spiritual and/or religious self as it may impact the doctor-patient relationship and help to sustain the practice of humanistic medicine. Learning Experience: Opportunities include joining a hospital chaplain on patient visits; interviewing patients with chronic illness, terminal illness and pain, and attending conferences/lectures and seminars. Complementary and alternative practices within the realm of spirituality will be included. Weekly seminars focus on discussions with core faculty facilitators and invited guests regarding the intersections of patient’s spirituality with clinical issues, assigned readings and research studies. Feedback & Evaluation: Students are encouraged to reflect on their experiences and reactions in small groups discussions with faculty and peers. Faculty writes comments in response to this essay. In addition, we write an end of year evaluation for each student using the standard elective evaluation form. Einstein students who need to fulfill their SP requirements can be mentored in this elective, if they pick a related topic to the elective. Location: Students need to report to Mimi McEvoy at the medical school, Belfer 507 on the first clinical day. Other settings: Calvary Hospital for 1 week; Home visits; Acupuncture with Sonia Lopez, MD at her site; In classroom discussions of readings in Belfer.
Mimi McEvoy, NP, MA
718-430-3167
mimi.mcevoy@einstein.yu.edu
Module: May only
Maximum: 6 students
FM527 Palliative Medicine Consultation Service (Bronx Lebanon)
The student will have intensive exposure to full spectrum palliative care inpatient activities with underserved African American, Latino and other largely minority patients. Objectives: Interview and examine patients and participate in family counseling with the guidance and assistance of the Palliative Medicine Consultation Service team members. Present and discuss care options for patients seen in consultation. Read didactic material on palliative care. Be provided with one-on-one teaching from the attending physician, nurse practitioner and social worker. Emphasis will be placed on the issues unique to end of life care faced by an inner city, underserved population. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Teaching attending physicians contribute to the final narrative evaluation. Learning Experience: Students will accompany palliative care team members, including nurse practitioners, social workers, physicians, and patient advocates. They will also conduct preliminary consults. Location: Bronx Lebanon Hospital Center, Milstein 7-F.
Dr. Joseph Sacco
718-960-1261
jsacco@bronxleb.org
Modules: All
Maximum: 2
FM528 Palliative Care (Montefiore Medical Center)
The purpose of this elective is to introduce fourth year medical students to the philosophy, principles and practice of Palliative Care. During the elective, the student will participate in the multidisciplinary team assessment and management of patients on the inpatient palliative care suite, on home hospice, and throughout the hospital, including patients in oncology, MICU, and the SICU. Formal didactic sessions will include teaching on pain and symptom management, the palliation of HIV disease, psychiatric issues at the end of life, advance directives and bioethical issues related to end of life care. Objective: Learn how to assess pain and non-pain symptoms. Observe palliative care assessment and management for the home visit. Recognize the role of the interdisciplinary team in hospice and palliative care. Describes how to assess and communicate prognosis. Describes the use of opiods in pain and non-pain symptom management. Describes the use of non-opiod analgesics, adjuvant analgesics, and other pharmocologic approaches to the management of both pain and non-pain symptoms. Recognize common social problems experienced by patients and families facing life-threatening conditions and describes appropriate clinical assessment and management. Demonstrates knowledge of, and recognizes limitations of, evidence-based medicine in palliative care. Use empathic and facilitating verbal behaviors such as: naming, affirmation, normalization, reflection, silence, listening, self-disclosure, and humor in an effective and appropriate manner. Demonstrate knowledge of the various settings and related structures for organizing, regulating, and financing care for patients at the end of life. Learning Experience: Students will have an overview lecture on palliative care, read selected review articles and take pre-and post-tests of palliative care knowledge. Students will assess new and follow up patients on the consultation and inpatient services under the direction of the course directors. Students will make home hospice visits and participate in interdisciplinary team discussions on patient care. Feedback & Evaluation: Students will receive formal feedback at the end of the rotation. The course director will complete a 360 assessment form with written comments. Location: Montefiore Medical Center
Dr. Jim Fausto
718-920-6378
jfausto@montefiore.org
Modules: All except July
Maximum: 1
FM529 Global Health in Guatemala
**NOT OFFERED TO VISITING STUDENTS**
There is a limited number of positions available for medical students in Central and South America. Research opportunities exist at a large HIV clinic in Guatemala City. Clinical opportunities exist in both rural and urban settings throughout the region. Interested students should send their CV's and a cover letter to either Dr. Anderson or Dr. Smith before registering. Objectives: Develop familiarity with clinical management of HIV in a non-HAART setting. Understand the social and economic context of HIV in Guatemala. Improve Spanish. Participate in an ongoing research problem. Learning Experience: Students will work in an HIV outpatient and inpatient care under supervision, visit CBO involve in HIV and participate in research. Feedback & Evaluation: Students will receive formal feedback weekly. Verbal reports of supervisors in Guatemala. Location: Clinica Luis Angel Garcia, Guatemala City, Guatemala
Dr. Matthew Anderson
718-933-2700
andersonma@aol.com
Modules: All
Maximum: 1
FM530 Medical Spanish Immersion in the Bronx
This elective will provide a Medical Spanish Immersion experience in the Bronx. Students will work with an interdisciplinary team and will conduct interviews and physicals with mono-lingual Spanish speaking patients. Two mornings a week the students will receive Medical Spanish instruction at the medical school. Intermediate Spanish is required (assessed by instructor). Objectives: Develop communicative competence to communicate with Spanish-speaking patients particularly in the Bronx community. Ask yes/no questions and open questions using different grammar tenses to avoid inaccuracy while conducting the medical interview in Spanish. Be familiar with some Spanglish terms used by Latino/Hispanic patients. Develop a wide variety of medical Spanish terminology through the textbook and Latino/Hispanic patients at the Mount Hope Family Practice. Learn about Latino/Hispanic patient's most common cultural and health beliefs. Learn about some herbal and home remedies used by the Latino population. Conduct interviews and review of systems in Spanish. Conduct health education for patients in Spanish with clinic team. Learning Objectives: The student will have intensive Spanish language instruction 2 mornings a week. At the clinic the student will conduct interviews and physicals in Spanish. Student is also expected to worth with clinic team (social worker, nurse) regarding Diabetes health education and support. Students will also be required to attend 2 seminars on Ethno medicinal plant use in the Latino population. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. Formal evaluation of Medical Spanish assessed by instructor testing, and an evaluation by the attending by observation of clinical and language skills. Location: First day of the elective the student will report to Dr. Cortijo for an orientation and oral assessment of Medical Spanish Most of the clinical experience will be at Mt. Hope Health Center supervised by Dr, Cortijo. Two mornings a week, the student will be at the medical school for intensive language instruction, and assessment.
Dr. Amarilys Cortijo
Medical Director, Mount Hope Family Practice
acortijo@institute2000.org
718-583-9000
Modules: April and May
Maximum: 2
FM810 Family Medicine Inpatient Service (Beth Israel Residency Program)
**NOT OFFERED TO VISITING STUDENTS**
The purpose of this rotation is to provide students with an experience in inpatient Family medicine Care. Family medicine doctors have the ability to see patients in their offices, and then to continue to follow them as inpatients. As a result, they often have a relationship prior to the admission, which can have beneficial impacts on patient care. This rotation is designed to give medical students some feel for this type of inpatient medicine. Objectives: Understand the experiences of "illness" and of becoming a "patient". Be available and able to share information and ideas about the sick person's situation to family members and friends, while at the same time respecting confidentiality. Demonstrate knowledge of common diseases treated in a family medicine inpatient setting. Develop proficiencies in carrying out an appropriate treatment plan for each patient. Demonstrate participation with the patient, family and all relevant members of the multi-disciplinary team in making good discharge plans. Demonstrate knowledge of indications for consultation, and how to communicate effectively with a consultant. Continue to develop the cooperative skills necessary for a family medicine team to share responsibility for a group of patients. Learning Experience: The students on this rotation will be spending their time in the inpatient setting with the Beth Israel Family Medicine inpatient team, composed of residents and attending. There is one call weekend day, and one call night per week. Family Medicine employs a night float team, so there is no overnight call. Medical students will encounter patients with diagnoses typical to an adult population in a tertiary care center (e.g., pneumonia, CHF, renal failure, HIV / AIDS, alcoholism, and liver failure). Feedback & Evaluation: Students will receive immediate feedback after procedures and observed counseling and the end of the rotation. The evaluation is compiled from feedback solicited by the supervising physician from the entire faculty who worked with the student. Location: The setting for the elective is Beth Israel Medical Center. Wednesday afternoon didactics are at the Institute Family Health site at 16 East 16th Street (near Union Square), and weekly Grand Rounds are Friday mornings at 10 Union Square.
Dr. Ray Teets
STUDENT MUST CONTACT SUB-INTERNSHIP COORDINATOR:
Dr. Maria Santos
718-430-2900
maria.santos@einstein.yu.edu
Modules: All except July and August
Maximum: 1
FM815 Urban Ambulatory Family Medicine (Beth Israel)
**NOT OFFERED TO VISITING STUDENTS**
The purpose of this rotation is to provide students with a variety of experiences that comprise Family Medicine in an urban, underserved setting. Clinical experience encompasses inpatient care, outpatient care, women's health, outpatient procedures, complementary and alternative medicine (CAM). Objectives: Gain clinical experience in CAM. Gain clinical experience in women's health/abortion care. Gain clinical experience in the homeless care setting. Demonstrate proficiency in patient care in the outpatient family medicine setting. Describe the differences of delivering primary in its various settings, e.g. community health care center, homeless shelter, women's health setting, CAM. Learning Experience: The students on this rotation will experience clinical care in various settings that Family Practitioners practice, as mentioned before. The goals of this rotation are to have the interested medical student gain more experience in Family Medicine, as well as gain experience in the various ways it can be practiced. Feedback & Evaluation: Students will receive immediate feedback after procedures and observed counseling and the end of the rotation. Evaluations are given to preceptors who have worked with the medical students two sessions or more, and from these evaluations an average grade is calculated. Location: The settings for the elective include Beth Israel Medical Center, Manhattan sites of the Institute for Family Health, and homeless sites with Manhattan. Students are to rotate to Zudith Lopez at 9am on the first day of elective. All of the preceptors are Family Medicine attendings and senior Family Medicine residents.
Dr. Ray Teets
212-206-5228
rteets@institute2000.org
Modules: All, except July and August
Maximum: 2
FM823 Women's Reproductive Health (Beth Israel)
**NOT OFFERED TO VISITING STUDENTS**
The purpose of this experience is twofold: to provide students with exposure to abortion care at Planned Parenthood and to provide them with experience in a Practice where abortion care is integrated or mainstreamed into the day to day family medicine practice. They will learn to counsel women with unintended pregnancies provide medication abortions and assist with aspiration abortions. They will also learn proactive contraception prescribing in order to prevent unintended pregnancies, including IUD insertion. Objectives: Demonstrate skill in informing a patient that she is pregnant and in options counseling. Describe the differences between suction abortion and medical abortion and know the indications and contraindications for each. Demonstrate an ability to compare and contrast the systems of health care provided by their family medicine practice as compared to Planned Parenthood's family planning clinic system. Establish proficiency in counseling women about all birth control methods while being sensitive to the cultural, economic, and psychological issues for any particular patient. Learning Experience: The students on this rotation will observe first trimester abortion training at Planned Parenthood of New York City, under the supervision of family physicians as part of the Clinician Training Initiative. They will observe the pre-abortion counseling that patients receive in this setting, as well as follow up medical abortion visits. They will share with residents and fellows in didactic sessions. The student will participate in the procedural sessions at the Phillips Family Practice where abortion care is also given and will learn to counsel women regarding options for unintended pregnancy and contraception. They will work in the Saturday woman's free clinic, and will work in the special teen/reproductive care evening session. The student will work under the reproductive health fellow during her precepting sessions, seeing patients which will be general family medicine patients as well as contraception and gynecologic issues. Feedback & Evaluation: Students will receive formal feedback after each procedure and observed counseling and the end of the rotation. The evaluation is compiled from feedback solicited by the supervising physician from the entire faculty who worked with the student. Location: The settings for the elective will be Planned Parenthood of NYC, Phillips Family Practice and the Women's Reproductive Health Care Free Clinic. The student will also participate in the weekly journal article discussion that occurs prior to the Wednesday procedure session.
Dr. Linda Prine and Dr. Ray Teets
(917) 920-2855
lindaprine@mac.com
Modules: All except July and August
Maximum: 1
FM900 Palliative Care (Jamaica Hospital Medical Center)
**NOT OFFERED TO VISITING STUDENTS**
Fourth year students with a dedicated interest in becoming family physicians will have the opportunity to work with the faculty and residents at the Jamaica Hospital Family Medicine Residency Program. This rotation includes both ambulatory and inpatient experiences in an urban, inner city environment in Queens, New York. Objectives: Students will: 1) review the epidemiology, natural history and treatment options for patients with common chronic, life-limiting conditions 2) recognize the importance of Palliative Care as a Multidisciplinary team 3) demonstrate knowledge of the general approach to the assessment and treatment of the patient with pain and non-pain symptoms 4) develop effective communication skills in “delivering bad news’, discuss prognosis and conduct a family meeting 5) acquire knowledge of the psychological, social, spiritual, cultural and ethical issues associated with end-of-life care. Learning Experience: Students will have an overview lecture on palliative care and an introduction to the Palliative Care service. Students will assess new and follow up patients on the consultation service under the direction of the course directors attending faculty and palliative care fellows. They will participate in all activities including direct patient care, family meetings, multidisciplinary team rounds, teaching rounds and didactic programs. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. The course directors will compile a final evaluation based upon the evaluations by all preceptors. Location: Jamaica Hospital Medical Center. First day students should report to: 89-06 135th Street Jamaica N.Y. 11418 Suite 3D at 9:00 a.m.
STUDENTS MUST CONTACT COURSE DIRECTOR FIRST.
Dr. Fernando Moreno
spadgett@jhmc.org and fmoreno@jhmc.org
718-206-6919
Modules: All
Maximum: 1
FM901 Urban Family Medicine (Jamaica Hospital Medical Center)
**NOT OFFERED TO VISITING STUDENTS**
Fourth year students with a dedicated interest in becoming family physicians will have the opportunity to work with the faculty and residents at the Jamaica Hospital Family Medicine Residency Program. This rotation includes both ambulatory and inpatient experiences in an urban, inner city environment in Queens, New York. Objectives: Students will: 1) enhance their level of competence in diagnosing and managing common problems that are seen in the office setting 2) foster an understanding of common problems that a family physician manages in the hospital setting 3) integrate bio-psychosocial approaches to the care of patients and their families. Learning Experience: The student will work with both faculty and residents seeing patients in our busy family practice center. Students will also spend one week working on our family medicine inpatient service. Finally, students will have the opportunity to go on a home visit and to work with our Palliative Care Fellowship if desired. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. The course directors will compile a final evaluation based upon the evaluations by all preceptors. Location: Jamaica Hospital Medical Center and the Family Medicine Center office. On the first day, the student will report to the Family Medicine Residency Center Administrative Office and ask for Ms. Shelly Padgett. Address: 89-06 135th Street Jamaica N.Y. 11418 Suite 3D at 9:00 a.m.
THIS ELECTIVE IS OPEN ONLY STUDENTS WITH A DEDICATED INTEREST IN FAMILY MEDICINE. STUDENTS MUST CONTACT THE CONTACT THE COURSE DIRECTOR FIRST.
Dr. David Dovnarsky
spadgett@jhmc.org
718-206-6748
Modules: July through December only.
Maximum: 1
FM910 Advanced Ambulatory Family Medicine (Mid-Hudson Family Practice Residency Program)
**NOT OFFERED TO VISITING STUDENTS**
This rotation is for students with an interest in Family Medicine as a career, offering a community-based experience in a small Hudson Valley city. Students will work in an active family medicine center seeing a wide variety of outpatient conditions in a diverse underserved patient population. Objectives: Explore career opportunities in Family Medicine. Improve patient care management utilizing an electronic health record. Gain a better understanding of biopsychosocial model of health care. Enhance communication skills. Develop an awareness of primary prevention practices. Learning Experience: Work with family medicine attendings and residents in a busy ambulatory teaching health center. Attend daily didactic conferences. Develop a relationship with a designated patient and meet with them on multiple occasions (office and/or home visits). Present a case-based talk to the residents/faculty based upon this patient. Feedback & Evaluation: Students will receive formal feedback midway and the end of the rotation. The course directors will compile a final evaluation based upon the evaluations by all preceptors. The student’s final evaluation will be a composite of feedback from their rotation preceptors, participation in conferences and performance on required Index Case Presentation. Important Information for Students about this Elective: Car required for travel between Hospital & Outpatient Center(s); Meals & parking provided at no cost;90 miles north of NYC, easy access to NYS Thruway; Outstanding recreational opportunities during downtime (hiking, skiing, rock climbing, etc.); Optional oncall which may include obstetrical opportunities. Location: Orientation held at Mid-Hudson Family Practice Residency Program, Administrative Office, Ms. Yisaira Mendez, 396 Broadway, Kingston, NY 12401
Dr. Mark Josefski
mjosefski@institute2000.org
Contact: Ms. Yisaira Mendez, 845-334-2700 ext. 2494, ymendez@institute2000.org
Modules: All
Maximum: 3, depending on housing availability
For any further questions regarding elective choices at Einstein/DFSM, please contact Ms. Adrianna Nieto, 718-430-2900 or adriana.nieto@einstein.yu.edu