Family Medicine is a core pillar of primary care and is where a ton of people receive their health care. There are many great things about family medicine and you can really have the opportunity to learn so much on your family medicine rotation.
In this blog post, I cover various aspects of the family medicine clinical rotation and tips I have for succeeding!
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Please note, this is just my personal experience and all opinions and recommendations on this blog are my own. My opinions and recommendations do not reflect the opinions or recommendations of my employers or school. I share all this information to share information I wish I would have known prior to my experiences. Everything on the blog is just my opinion and experiences.
My family medicine rotation experience
In PA school, I had three different family medicine rotations, which I think has been an amazing experience to see how different family medicine and primary care clinics work. While they were all family medicine rotations, they all were very different experiences, and I learned a lot from each family medicine practice.
I worked in family medicine prior to PA school, so it has been a really cool, full-circle experience to see family medicine from the other side in the provider role.
Some things I learned on my family medicine rotations
-Patients have a lot of different stuff going on
While the chief complaint on the chart may say “nasal congestion,” there is a 99.9% there’s probably something else going on too. People often have many things they want to talk about and a case may not be as straight forward as it seems.
-The answer may or may not be as simple as it seems
When patients present with certain symptoms, sometimes the diagnosis is as straightforward as it seems, but you often have to rule out certain conditions depending on what the symptoms are. While ruling out possible causes or other conditions, you may end up finding conditions/diagnoses you weren’t expecting.
-Spend the extra time to help your patient understand
Studies have shown (numerous times) that when a patient understands their treatment or diagnosis, they are more likely to be compliant with their treatment (which produces better outcomes for them!). This also applies to testing and lifestyle recommendations.
For example, if a patient doesn’t understand the consequences of high cholesterol, they are less likely take a medication addressing their hyperlipidemia. But if they understand that lowering their cholesterol lowers plaque buildup in their blood vessels which decreases the damage to their heart, they will see that high cholesterol is a lot more than just a high number on their lab results paper, and will be more likely to take treatments or lifestyle changes they may need. Taking the few extra minutes to explain, could theoretically be the difference between a patient having a heart attack or not.
-As always, it is important to care
Some of the biggest complaints that patients have boil down to they didn’t feel cared for. Whether their complaint is that the visit felt rushed or they didn’t get the medication (like antibiotics) they had hoped for, it is often because they didn’t feel like they got the care that they deserved. Everyone deserves good care and to feel like they are cared for. It is important that the patient knows that they are heard and that the provider is truly looking in the patient’s best interests. Take the extra moment to care, even when it is a busy time or the end of the day or someone is being rude.
-Family medicine is busy
Rotating with family medicine, you will see many different patients in one day. One thing that differs a lot from hospital medicine is that while in the hospital you may be managing many patients all at once, in family medicine, since there are appointments ranging from 15 to 30+ minutes, you will focus completely on one patient and finish up most things regarding that patient before moving to the next patient.
********Let me preface by saying that these things aren’t always easy, but that they’re what I’ve learned and want to implement or improve in my practice. **********
Important Topics to Study for Family Medicine
****If you know these well on your first day of your family medicine rotation, you will be prepared to answer frequently asked questions by preceptors on your family medicine rotation***********
- USPSTF Screening Guidelines (colon cancer screening, breast cancer screening, lung cancer screening, hyperlipidemia screening, etc)
- Vaccination Schedule
- Management of hyperlipidemia
- Management of hypertension
- Diabetes Management (and different types of insulin and dosing)
- Treatment and diagnosis for upper respiratory infections
- Antibiotics, especially for the HEENT and Genitourinary
There are so many topics to know, but I think that these topics are ones to know like the back of your hand because they are constantly coming up.
What was in my white coat pockets on FM rotation
- Small Pocket Notebook
- 2 pens of different colors (I love MUJI pens, I always have a red and a navy blue on me. They’re cheap and look a little different so no one ever steals your pens lol)
- Stethoscope (Mine is the Littman Cardiology 4, but I also have the Littman 3 which I like and is cheaper.) If your school doesn’t require a specific stethoscope, any decent stethoscope is usually fine.
- My phone (handy to quickly look up a medication dose or calculate a ASCVD score). I recommend the app MdCalc app to calculate any scores- CHADS-VASc, ASCVD, GCS, SOFA, HAS-BLED, APGAR etc)
- Specific to my rotation sites: I did a lot of IM injections on one of my family medicine rotations, so I always kept a small supply of alcohol wipes and band-aids in my pocket too. If there’s something you use often, but can’t ever seem to find, not a bad idea to keep an extra in your pocket for quick use.
Tips for succeeding on your family medicine rotation
Listen to your patient
Allow your patient to be heard. They know more about what is going on in their life than anyone else. If something they’re saying doesn’t make sense, ask more questions. They are there for you to help them, and how can you help them if you’re not even listening? Lab work and imaging can only tell you so much, the patient can tell you so much more.
Formulate a diagnosis and plan in your head
Try to learn from each patient the most you can. One of my family medicine preceptors told me that something she wished she had done more while she was a student was to formulate a diagnosis and entire plan in her head with each patient to practice what being an actual provider is like. She would go through the whole visit while I followed her and later when we stepped out of the patient’s room, she would ask me what my whole plan was. This exercise was a great experience to think more of everything to prescribe, order, or document for the patient. Doing this is something that I wish I had started doing earlier in the course of my rotations.
Don’t forget health maintenance
In family medicine, even if a patient is there for a skin rash, you still need to go over other aspects of their health, including if they need medication refills, are due for the flu vaccine, or need a referral for a colon cancer screening. All practices or clinics may do this slightly different, but make sure you’re addressing everything with the patient that you need to.
Take good notes
Since you see so many patients in family medicine, make sure you’re taking good notes for yourself. You may think you’ll definitely remember that interesting case or the odd supplement that your preceptor prescribed, but with the amount of stuff you’ll see, you will probably forget some interesting and cool stuff. I recommend keeping good notes of the different patients so that you can review cases later and have questions ready to ask your preceptor.
Help out the staff
In family medicine, there is a lot of opportunities to help out the staff. Whether it is getting a blood pressure, giving an injection, or doing a flu test, you can be really helpful to the staff and get a lot of experience at the same time. Nurses, medical assistants, and techs are all usually eager to let you help and will teach you useful information along the way.
(Before PA school, I was a medical assistant and always loved if a student was interested in what I was doing or wanted to learn something!)
If you don’t understand a treatment or diagnosis or are confused about something, ask a question! While you may not have opportunities to ask questions during certain parts of the day, write down any questions you may have to ask when there is an opportunity. Asking questions shows that you’re interested and can help you better understand why something is done.
Study Resources for Family Medicine
There are a lot of resources available for family medicine and I used a lot of different ones. Below are some of my favorites.
Rosh Review is my go to for practice questions. I love that after you answer a question, it will give you a whole explanation of the condition and why each of the choices was right or wrong. It does cost a bit, but to me the yearly subscription was definitely well worth the amount it cost.
First Line Guide
As usual, First Line Guide is a super awesome resource for learning and reviewing diagnoses and treatments. I love the layout of First Line Guide and how the topics are organized.
(If you’re interested, I did some of the heart and lung illustrations throughout the cardiovascular and pulmonary sections 🙂 )
Pance Prep Pearls
Pance Prep Pearls is a classic PA study supplement. It is really informational and is a great review tool. Personally I find the organization a little more confusing, but it is still really useful. Some of my classmates absolutely love Pance Prep Pearls.
I use my old class notes to make study guides on topics that I could be tested on for each rotation. If you’re interested in how I make my charts and study, check out my blog post on the subject.
Family Practice Notebook
On my third family medicine rotation, I found the Family Practice Notebook which is a FREE open resource database with a breakdown on thousands of topics and links to external resources. It reminds me of UpToDate, but it is completely free. Since it is open source, I would be careful about using information you find here to treat patients, but it is a super great review source and great to quickly look up a topic you are less familiar with.
If you’re interested in seeing how I study for rotation exams, see my blog post all about studying for clinical rotations.
This concludes my recap on surviving your family medicine clinical rotation in PA school. Let me know if you have any questions.
Thanks for reading!