The patients seen in a family practice also support students’ learning in a myriad of ways:
1. “...patients seen in a family practice more closely represent the demography of illness in the community; undifferentiated patients seen in the earliest stages of their illnesses are more appropriate for learning clinical reasoning..” (1)
Seeing patients with new concerns, who have not yet been “worked up” will allow you to practise your data gathering skills, apply your content knowledge and develop differentials, unbiased by other’s clinical assessments. The range of clinical problems that you will encounter in family medicine, including management of acute, undifferentiated problems; ongoing care of chronic disease; disease prevention, health promotion, and rehabilitation, will also help you to transfer, apply and transform your pre-clerkship learning. You will see diseases that are rare in hospital but very common causes of human suffering, while learning generalist skills.
2. “...ambulatory patients are more autonomous and are better-suited for learning clinical judgement and finding common ground..” (1)
Patients seen in hospital are often too ill to actively participate in their care. This often results, by default, in very physician-centred care; it’s difficult to address the patient’s agenda, including functional limitations, ideas, concerns, and expectations, when these are largely unknown.
3. “...personal, family and other contextual factors are more apparent, thus demonstrating the importance of addressing all of the determinants of illness; care is provided over many years, thus illustrating the central role of the patient-physician relationship.” (1)
Following patients over time and from the vantage point of the community in which their patients live, enable family physicians to develop strong connections to their patients and deep understanding of factors influencing patients’ experiences with illness. As a community-based discipline, you will have opportunity to work with a network of health care providers, developing your collaborative, and at times, leadership, skills in team-based care.
Both your clinical experiences, as well as your project work will help you develop the comprehensive approach to patient care, typical of family medicine. This will help you to respond to the patient expectation of: “...more than technical expertise; ...[patients] want physicians to connect with them at a human level, listen intently to their concerns and involve them in decisions about their care.” This approach will also help to ensure that your hard work, including classroom and “book learning”, maximally contributes to reducing human suffering and promoting health and wellness. More information about MDCN 502, assignments and instructions are located in the core document at the bottom of this page.
In addition to excellent clinical learning opportunities, family medicine clerkship will give you an “inside view” of the field. Even if you do not feel that family medicine is a “good fit” for you, having a broad understanding of the discipline is critical to your own future practice, given that “family medicine is the foundation on which the delivery of medical care in Canada is based”. (2)
Have a fantastic 6 weeks!
Dr Sonja Wicklum, MD CCFP FCFP
Family Medicine Clerkship Director
Clinical Assistant Professor
1. Rethinking Undergraduate Medical Education – A View From Family Medicine. The College of Family Physicians of Canada, 2007.
2. “University of Calgary Task Force on Family Medicine as a Career Choice” 2009.
Link: Core Document (PDF)