1. POSTER TEMPLATE BY: www.PosterPresentations.com Improving Family Medicine’s “Coolness Factor”: The University at Buffalo Family Medicine Experience Enhancement Project Stephanie W. Chow, M.D. and David Holmes, M.D. State University of New York at Buffalo School of Medicine and Biomedical Sciences Introduction Many medical students openly admit that their decisions to go into Family Medicine are negatively affected by the dismissive attitudes and “bashing” stereotypes from those in other specialties. Interest in Family Medicine suffers in many medical schools, largely due to under-valued skill sets and misinformed stereotyping. As a newly reorganized student-run club, the Family Medicine Interest Group at the University at Buffalo School of Medicine (UB) studied the experiences of medical students from various institutions and then proposed a framework for enhancing the diversity and enjoyable experience of family medicine education. Recommendations included clarifying the philosophy of family medicine (FM), educating students on the different “flavors” of FM, introducing an earlier FM curriculum, team working with other primary care groups, public health education, and, most importantly, improving the “coolness factor” of FM. This independent study project, entitled the “Family Medicine Experience Enhancement Project” (FaMEEP), was inspired by a senior student who desired to improve the future experiences of her medical school colleagues. Through the strong efforts of the Family Medicine Interest Group (FMIG), our medical school saw an astonishing increase in the enthusiasm and desirability of Family Medicine. FaMEEP Project Goals ABAB Assessing Your Success Contact Information 1.Educate students about the history and philosophy of Family Medicine 2.Educate students about the different flavors of Family Medicine 3.Introduce Family Medicine earlier in the medical school 4.Bolster strength in primary care 5.Improve the “coolness” factors of Family Medicine 6.Increase participation in Family Medicine Interest Group (FMIG) events 7.Introduce public health from the primary care perspective Define Family Medicine For Your School Identify misconceptions Family Medicine does NOT = IM + Pediatrics + OB/GYN Differences in inpatient IM vs. FM Clarify misconceptions FM is NOT all about chronic health conditions FM is NOT “jack-of-all-trades, master-of-none” FM is NOT geeky Identify new desired territories Medical school Community leadership Community education and public health Flavors of Family Medicine Urban, Rural, Suburban, Complementary and Alternative, Osteopathic and Allopathic, Underserved and Affluent, International Setting Up Your Foundation Skills : Labs & imaging (Radiograph interpretation, CTs, MRIs, EKGs, labs) Procedures: Surgery/Trauma (suturing, knot tying, joint injection, casting) Lecture: Cost effective medicine, Healthcare and Public policy A pre- and post- test questionnaire was administered to assess workshop effectiveness. While only a rudimentary measurement, 1 st and 2 nd years demonstrated a marked improvement in comfort of procedures while 3 rd years reported no change except in further affirmation of their interest in FM. Overall students participating in FaMEEP demonstrated increased interest in primary care although a true cause-and-effect relationship cannot be proven at this time. Skills: Continuity of Care (prenatal exam, newborn exam, developmental milestones) Procedures: OB/GYN (uncomplicated vaginal deliveries, maneuvers, pelvic and cervical exam) Lecture: Other flavors of FM, fellowship opportunities Lecture: Family Medicine Department Chairman and other faculty leaders Q&A panel with matched 4 th years, residents, attendings Other opportunities in FM (fellowships, research, etc.) Networking Demonstrating the inspiring appeal of continuity of patient care is essential to your marketing process. Continuity of care is a unique component to Family Medicine, and is impossible to conceive within a 6-week clerkship. Therefore, schools must be creative in simulating these experiences. For example, introduce Family Medicine in the 1 st year as a longitudinal curriculum. The student is paired with a FM resident to follow a “continuity” patient throughout 1 st - 3 rd year or may opt to attend group visits. Consider creating a 1 st /2 nd year elective course in “Continuity of Care.” Activate FMIG and keep its presence well known. Forward Thinking Recommendations Department of Family Medicine University at Buffalo School of Medicine 202 Farber Hall Buffalo, NY 14214 ubfmig@gmail.comubfmig@gmail.com, swchow@alum.mit.edu, dholmes@buffalo.eduswchow@alum.mit.edudholmes@buffalo.edu. We will likely never have a true way of knowing what our successors will need to know in the future, and so our teaching methods and approaches must change with each generation. The FaMEEP only demonstrates recommendations for a short term period and relies on the student leaders in each class to incorporate generational FM trends as we move forward in time. As newly minted interns in Family Medicine residency programs across the United States, my graduated colleagues and I make the following “forward thinking” recommendations to the medical schools invested in the latest student interest trends: 1.PUBLIC HEALTH Public Health electives and combined MD/MPH degrees 2.Costs of being in primary care Costs of healthcare and business finances. How much does it cost to run your own business? ICD-9 coding and leveling of clinic visits Choosing to do obstetrics Serving the underserved, International Medicine 3.The business side of things Introduction to Practice Management Different forms of clinical practice: academic, community, micropractice 4.What kind of primary care doctor do you want to be? Academic, community, solo practice, underserved, specialist, hospitalist, rural, nursing home/geriatrics 5.Fellowships Faculty development Geriatrics Obstetrics, Maternal-Child Health Preventive Medicine Research Rural Medicine Sports Medicine Also combined residency programs available: FM/Preventive Med, FM/Psychiatry, FM/OB, FM/EM Comparing Across Schools NorthE = Northeast, NE = New England, NYC = New York City, MidW = Midwest School Region Clinical ClerkshipPublic Health/Preventive Care experiences Extra Activities/FMIGStudents entering FM / class % A NorthE 3 weeks inpatient, 3 weeks outpatient, rural rotation available, Monday lectures mandatory Preventive care lectures, little public health exposure FMIG newly revived. Generalist Scholars program 5-13 students / 3.5 – 9% Affiliated residency program B NorthE 6 weeks ambulatory family medicine: 3 clinic system where student rotates back and forth between all sites. May choose rural or urban. No lectures. Some epidemiology lectures. FMIG exists3-5 students Affiliated residency program / 2.5% C NorthE 1 month clerkship at community hospital, 3 hour lecture once weekly. Full day outpatient experience several times weekly. No geriatric medicine training. Students may study to receive an MPH within the same 4 years of medical school if they choose FMIG exists. Very active.3-5 students Affiliated residency program / 3.5% D NE Students divided among 3 clinics (2 urban, 1 rural) FMIG very active.10 students Affiliated residency program / 8.8% E NE None. There are a few electives available with FM preceptors who have loose affiliations to the medical school. Most require traveling out of the city and paying for additional housing. Generally set up as 4 th year away electives. Students must choose 2 public health courses, usually offered jointly with the school of public health Primary care interest group. $60,000 loan-payback incentive for those choosing primary care. 0-1 student / < 1% No affiliated residency program F NE No required FM clerkship. Students may choose to do an away elective in FM. 1 semester long course that includes several health-related epidemiology issues in the US and globally, as well as issues related to occupational health FMIG exists but is minimally active. 1-2 students / < 2% No affiliated residency program G NE 1 month during 3 rd year. Mostly in rural sites. Lectures at beginning of rotation for orientation to musculoskeletal medicine and at the end of rotation students presented projects done during the month aiming to help the individual clinic sites. Some public health integrated into a global health curriculum. Community projects in 2 nd year. Primary care very active. Many lunch lectures. Supportive faculty. Plentiful funding for students to attend national conferences. 12 students / 11.2% Affiliated residency program H NYC 1 month clerkship, student sent to outpatient clinics around NYC/NJ. T-R clinic. M+F lectures from 8-3 that included didactics, student presentations, and a community related group project. Some public health lectures FMIG exists but is not well known 2-5 / 2.2% Affiliated residency program I NYC 5 week primary care clerkship in which half of the students go to a IM clinic and the other half go to a FM clinic. Interested students may elect to work at the rural medicine Indian reservation in New Mexico. May choose to go to other locations. Students will later have 10 weeks of inpatient IM. Brief epidemiology course in 1 st year FMIG exists but is not well known 2 / 1% Affiliated residency program J MidW 3 rd year. 6 weeks all outpatient medicine at an urban site. Rural optional. Students spend 1 day per week each at the student clinic, community outreach center, and lectures. Will also have 3 weeks each of ambulatory medicine geriatrics. Students receive their 8wk inpatient experience during IM. Public health module for 4 weeks in fourth year. Each day students meet for 4 hours of lecture. Required to complete a public health group project. FMIG exists. Faculty and school make big efforts to promote FM. Many school wide events with good funding and heavy student activism. Students may also pursue a “Community Leadership” track. 10 / 6.3% Affiliated residency program Workshop #1: Introduction to FM (What is it?) Workshop #2: Introduction to Continuity of Care; Other Flavors of FM Workshop #3: Further Explorations in FM