Each Senior Clinician will work independently under the direct clinical supervision of the attending physician.  The Clinic Coordinator will oversee all administrative and operational aspects of the clinic and the Senior Clinician should look to the Coordinator for guidance in these matters.

Requirements

  1. Completion of 5 weeks of either medicine or primary care
  2. Participation in a CoSMO orientation session

Saturday Responsibilities

  1. Arrive at CoSMO by 8:30am
  2. The Clinic Coordinator will assign a Junior Clinician for you to work with during the day.
  3. Each student clinician will be assigned an exam room in which to see patients.  On any given Saturday the student clinician will see between one and three patients.  This necessitates an efficient, but thorough, approach to each patient encounter.
  4. The Senior Clinician will receive a thorough orientation from the Clinic Coordinator upon arrival at clinic. You will be paired with a Junior Clinician who is yours to teach for the day!
  5. All patient encounters require a note to be entered in Eclipsys. PLEASE BRING YOUR ECLIPSYS ID AND PASSWORD TO CLINIC. If you are not able to document your encounter in Eclipsys, you will NOT be able to see patients that day (and, specifically, are NOT allowed to enter a note under ANYONE else’s name but your own!). After you present the case to the attending, he or she will write an addendum to your note and this document will go in the patient’s record.
  6. Present to the attending.  With the attending you must decide on an appropriate course of action and the category of any medications[1] that the patient requires.
  7. After you have finished discussing the case with the attending and completed your note, hand the session coordinator the chart with a list that includes: the class of medications the patient needs, return visit timing, referrals, lab studies, and/or x-rays that the patient needs.  The session coordinator will take it from there.

Helpful Hints

  1. Telephone interpreters are available at clinic.
  2. Unlike the wards and primary care rotations, at the end of the day, you have much more responsibility, especially when it comes to teaching the Junior Clinician.  This is a unique teaching experience that we usually do not get as medical students.  Try to think about the Junior Clinician and whether he/she is having a valuable experience.  As you see fit and are comfortable, feel free to teach the Junior Clinician how to do the physical or allow them to take as much of the history as they can with you interjecting as necessary.  Perhaps even teach him/her to do a portion of the presentation for the attending.  It is entirely up to you how you prefer to structure the patient encounter and the presentation to the Attending Physician in order to incorporate student learning in light of potential time constraints.
  3. There is an onsite Health Educator who is skilled at discussing nutrition, exercise, cancer screening, hypertension, diabetes and high cholesterol.  Utilize their services as needed either by contacting them directly or letting the coordinator know.
  4. Bring your own opthalmoscope/otoscope.
  5. You are free to wait until the end of clinic to enter the Eclipsys notes.
  6. Think fast and efficient.  As interns we will be seeing anywhere from 6-10 patients in a morning/afternoon.  Scary!

Interested?

CoSMO is actively recruiting the participation of additional senior physicians. If you are interested, please email hr@cosmoprimarycare.org


[1] To clarify the meaning of “category of medication”:  the pharmacy program that we are using remains complicated and cumbersome.  To save your time and allow you to focus on the patient encounter and care we are going to have the session coordinator deal with the specifics of medication choice.  So, what you will need to tell the coordinator is merely what classification of medication the patient requires, for example, hypoglycemic, beta-blocker, or diuretic.  The student coordinator will then sit with the attending and look through the pharmaceutical options available to us and select a specific drug.