Community Medicine

Overview:

Community Medicine is a required two-week rotation in the HSM curriculum and occurs in the third year of residency. It is primarily an experiential rotation which is supplemented with self-directed readings. Longitudinal didactics and computer based learning modules are also included in this curriculum. In the experiential segment, time is divided between public health agencies, educational facilities, occupational health facilities and sites which serve underserved and minority populations. Teaching is provided on site by authorized individuals. The rotation is supervised by a full-time faculty of the program.

Goals:

The Community Medicine rotation experience shall:

• provide a structured learning experience in community medicine

• provide experiences in multidisciplinary settings which impact the health of the community

• train the resident in health care practices and resources that optimize the health of diverse populations

• develop attitudes and skills which will enable and encourage the resident to identify and use aspects of the community which affect patient health

Objectives:

At the completion of this rotation, the resident will have demonstrated to the satisfaction of the supervising faculty:

• medical knowledge in community medicine relevant to the practice of Family Medicine, including: (MK)

  • assessment of risks for abuse, neglect, and family and community violence and address those risks

  • how and where to file epidemiological reports in cases of reportable diseases

  • how and where to obtain and interpret epidemiological information

  • how to recognize and address environmental threats to safety and health in the community

  • procedures and functions of the School Health Program regarding medication policies, ADD/ADHD referral and treatment, and special education issues

  • disease prevention through immunization strategies

  • disaster responsiveness

  • community-based disease screening, prevention and health promotion

  • factors associated with differential health status among sub-populations

• participation in clinical experiences pertinent to community health, including: (PC)

  • using community resources appropriately for individual patients who have unmet medical or social support needs

  • structured interactions with the public health system

  • occupational medicine clinic

  • community health assessment

  • programs to address community health needs

  • community-based health education of children and adults

Implementation:

This is a multifaceted rotation that provides multiple training experiences in a variety of settings, which is augmented by self-directed readings, computer based learning, noon conference didactics and longitudinal learning in the behavioral science curriculum.

Experiential based learning components :

Residents meet with professionals in the areas of: the county health department; occupational health; domestic/child abuse; addictions resources; developmental disabilities; HIV/AIDS; minority health; school health; and hospice. Residents also are required to give community health talks, participate in community health screenings, and complete a home visit with the behavioral scientist.

The program administrator assists the resident in scheduling time with the various sites and professionals. The resident must continue to meet the usual residency obligations to his/her Family Medicine Center population, including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital, and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.

Didactics:

Portions of the curriculum are also taught at noon conferences on a regular basis over the three years of training. The conferences are presented by physicians, the behavioral science team, and experts in utilization of community health and resources for underserved and special populations.

Self-directed Learning:

Residents are given a copy of selected readings in Community Medicine. Adequate time is made available in the rotation schedule for the resident to become familiar with this material.

Computer based learning modules available on the hospital intranet cover subjects such as disaster preparedness, infection control, emergency preparedness, fire safety, hazard communication and electrical safety.

Evaluation:

Each professional with whom the resident meets completes a brief evaluation of the resident. The resident must also pass, with a minimum score of 75% correct, a quiz designed to evaluate the resident's knowledge of community medicine.

A rotation evaluation is completed by the supervising faculty based on input from the resident, supervisors at the various agencies, professionals met with during experiential components and the quiz results.