Medical Students
Fourth Year
We are excited that you are considering a rotation with us as a fourth year medical student. Our program participates in the Texas Statewide Preceptorship Program and scheduling your rotation will be coordinated through their office. You can get information and complete an application for a rotation via their website.
As a fourth-year medical student, you are welcome here. We are really looking forward to working with you. There is no better way to gain an understanding of how a residency program works than to spend time actually working “in the trenches.” We feel confident that you will appreciate just how committed we are to excellence in medical education and clinical care during your time with us. We hope that you will also develop a better understanding of the role, the value and the joy of family medicine. We want you to see our educational program and our facilities, and the value we place on teaching, resident development and resident well-being.
We encourage our senior medical students to function as junior interns. Our expectation is that your four-week experience will include inpatient, outpatient and maternity service exposure.
You will be assigned to begin a two week block in obstetrics or family medicine inpatient service and midway through your four-week rotation you will change to the other service. This is not a rigid schedule. If you have certain goals for your rotation please allow us to address them with a more personally tailored rotation.
Family Health Center
When they work in the Family Health Center (FHC), we will attempt to place the fourth-year medical students with senior residents in order to maximize clinic flow and exposure to patients. While working in the outpatient clinics, you will have the opportunity to provide the initial patient contact with appropriate resident and faculty oversight. The clinic hours are from 8:30 a.m. to 12:30 p.m. and 1:30 p.m. to 5:30 p.m. (closed Thursday afternoons for lectures).
OB Service
You are to be on the fourth floor, labor and delivery at 7 a.m. to round with residents and faculty. The chief resident will assign you patients. You will be discussing cases that you will then evaluate. The resident will assist you.
Morning rounds generally last from 7 to 8:30 a.m. on the fourth floor with the OB team and attending. You will then round on postpartum patients on the third floor. You will stay on the fourth floor (L&D) for deliveries until 6 p.m. While on L&D you and the resident will evaluate patients in the triage area ("the labor lounge"), the LDR (labor-delivery-recovery) rooms or the antepartum ward (the "annex"). You will obtain histories and perform physical exams prior to the residents seeing the patients, as well as cervical and sterile speculum exams with the resident. You may observe invasive procedures that the resident performs (e.g. artificial rupture of membranes, fetal scalp electrode or intrauterine pressure catheter placement). You may attend and participate in deliveries (vaginal and Cesarean—yes, you will deliver babies!) with the resident. Please note that you are not allowed to perform invasive procedures or vaginal deliveries without a faculty or upper-level resident physician present. You or the resident should seek the permission of the private OB physicians if you wish to participate in their patients' evaluations, care and deliveries. Again, the resident will assist you in all of these activities.
While there is no “overnight” call for you on L&D, we do encourage you to stay a bit late, if there is a patient you have been following who is going to deliver later in the evening. (There is no sense in working all day and not seeing the fruits of “your” labor!)
FM Inpatient Service
During this rotation you will function as member of the inpatient family medicine service. You will be expected to pre-round on one to two patients per day (see and examine the patient and write a progress note). You will then present this patient to the rest of the team at morning report from 8 to 10 a.m. every day. There will also be a resident rounding and writing notes on patients that you will follow—however, your presentation and progress notes are important for patient care and you will be evaluated on how well you are able to gather clinical data and present this data in an organized manner.
The second-year resident on the team, in addition to the chief of service, will serve as a help and resource for you. After morning report, work rounds with the team are from 10 a.m. to 12 p.m. You will also attend all noon conferences with the residents. You will be expected to take one “short call” each week while on the inpatient service. The best nights for you to take short call are our ER call nights, which tend to be busy and very educational. Your third year resident will work with you in selecting these scheduled dates.
In the afternoons, you will either be working with residents in the clinic or working in the hospital with the resident who is carrying the call pager. You can discuss your preference with Dr. Thames or chief of service to work out the details of your schedule.
On the first day of your rotation you are to report at 8 a.m. to the Family Medicine Administrative Offices on the fourth floor of the Goldsbury Building, Suite F4703. At that time, you will be provided with your schedule for the 4 weeks as well as a CHRISTUS identification badge and permit for our parking garage. You will be oriented to the clinic and hospital at that time. Should you have any questions, please feel free to call the program at 210-704-2575 or 210-704-2535.
Expectations
- We want you to have a good learning experience. You will be treated as a member of our health care team and be given responsibility commensurate to your experiences and desires. Although we have developed a rotation that will be educational for you, please let us know if you have any special interests so that we can try to address those specific requests.
- Regardless of your ultimate career plans, we believe we have something to add to your undergraduate education. If you are interested in primary care, we hope you gain an appreciation of the value a well trained family physician brings to a community and to the practice of medicine. If you are focused on another specialty choice, we believe that all physicians are made better by an understanding of the foundation of primary care. If you are undecided, we would be happy to talk with you about making the most important decision of your professional life.
- We want you to develop an understanding of family medicine and, hopefully, a glimmer of the joy and sense of reward and accomplishment found in long-term patient relationships.
- We want you to see our residency program, and we want to help you with your ultimate career choices regarding specialty selection and residency training. We hope that you will see the commitment and skill of our faculty and the quality of our resident. We want you to see how we work together and how we continually work to improve our program.
- We expect you to act professionally throughout the time that you are here. That professionalism includes appropriate behavior, dress, attendance, punctuality, and a respect for patient confidentiality and privacy. Our chief residents or one of our faculty will discuss these issues with you when you arrive.
- We want you to have fun. We love what we do and hope you will share in that passion. We work hard, but we laugh a lot. Although we are always delighted to receive positive comments about your experiences, we also believe that we improve by receiving constructive criticism; feel free to provide us with your feedback.
