Family Medicine consists of a total of 4 weeks, and you can spend your time in the outpatient clinic either in Thunderbird, Arrowhead, San Tan, Wisconsin, or another Mayo campus. Family Medicine is a clerkship that has lighter working hours that represent closer to an 8am-5pm but keep in mind that you will have to find time to pre-chart on your assigned clinic patients, so hours can easily become 7:30 - 5:30! There are some additional tasks that need to be done as part of the clerkship that requires some more busy work. Refer to Bright Space for full details of content and requirements. The great thing about this rotation is that you receive a thorough orientation with the clerkship director on day one and they will explain all criteria and details to you! Dr. Winscott will send reminders for assignments and is very responsive by email.
Students must score greater or equal to the 10th percentile on the NBME exam (110 questions) in order to receive a pass.
We no longer use the Aquifer exams. You will be required to do one Aquifer exam in the first week, but it is only for completion.
Students will be evaluated by all the faculty with whom they worked for at least 3 half days through MedHub evaluations.
Students will also have to complete a Wise and Warm Simulation with the Office of Patient Experience.
Dr. Winscott will fill out the CEX for you based on the simulation. No need to worry about this if you do FM in Arizona.
Students must complete two portal messaging write-ups, each worth 25 points.
Assignments:
Wise and Warm Simulation: 100 points
Panel management portal writing assignment: 25 points
Portal writing assignment: 25 points
Student presentation: 25 points
Student reflection: 25 points
Pass:
Average preceptor score >= 2.2, minimum 100/200 of assignment points, pass NBME shelf exam on 1st or 2nd try.
High Pass: Meet all criteria for Pass, PLUS both of the following:
Average preceptor score >= 2.7
Minimum 150/200 of assignment points
Honors: Meet all criteria for High Pass, PLUS any one of the following:
>=90th percentile on shelf exam
Overall average preceptor score >= 4.0
>4.0 on MedHub questions 4, 5, 6, 10, 11, 12
>4.0 on MedHub questions 7, 8, 9
>4.0 on Medhub questions 13, 14 AND >90% of assignment points
5.0 on Medhub questions 1-3
*No limit to the number of Honors per rotation.
Each student is usually assigned two clinic locations (Thunderbird + San Tan, Thunderbird + Arrowhead, etc.) and they work with a variety of preceptors throughout the week. Sometimes you might be in one location for part of the week and then another for the other half. You may be assigned to work with one preceptor in the AM and a different one in the PM. It is crucial that you email each preceptor the day before and ask them which patients are assigned to you. Typically, you will be assigned 2 patients in the morning and 2 in the afternoon with the expectation that you will pre-chart on them, see them, staff with the preceptor, and write a note on the visit. When introducing yourself to the preceptor, make it clear where along in your rotations you are (whether this is your 1st rotation vs. 5th rotation) so they know what to expect.
The typical schedule here is 8am to 5pm. You will need to find time to pre-chart on your patients. Most of the time once you are done with your note at the end of the day you may review it with a preceptor and be ready to head out! So work towards becoming efficient in note-writing so you can buy some time back into your day.
You will also be doing some virtual visits. You can do these from home, or email Dr. Winscott, and she can assign you a room at Thunderbird to conduct these visits. Your schedule during days with virtual visits is usually more flexible.
Thunderbird
Phoenix (next to the hospital)
San Tan
Arrowhead
Eau Claire, Wisconsin (*see site specific information)
Clinical Performance Evaluation
Make sure you email each preceptor the day before you work with them and ask them to specify which patients you are responsible for seeing the next day (the usual is 2 in the morning and 2 in the afternoon).
You should pre-chart on your patients.
See the patient by yourself first.
Pend any orders and diagnoses you think might be warranted (it's ok if they're not entirely correct, they can always be deleted/edited, but you want to show that you're thinking about next steps). Make sure to review USPSTF guidelines and pend orders for screenings (colonoscopy, mammogram) accordingly.
Present to the attending and then see the patient together.
Finalize any orders for the visit, and write your note!
For clinic, make sure you preview patients in Epic before you see them. Have a good understanding of why the patient is being seen, any relevant past medical history, relevant medications, care gaps (i.e. vaccinations, breast exam, pap smear, colonoscopy, etc.) and review any intermittent emergency room or urgent care visit notes.
In Epic these are the key tabs you can go through
Snapshot
Encounters (read the notes from the gyn department)
Results Review (for imaging & pap smears)
Document Viewer / Care Everywhere (for new patients that may have transferred clinical documents from prior gyn outside of Mayo)
Care gaps
When writing notes in Epic it’s a good idea to ask your faculty if they have a preferred template they use. Copy their template and use it instead of trying to figure out what to do or starting from scratch! Read one of their prior notes and try to follow that format and language. See below for some template recommendations. Dr. Winscott will also set you up with a template on your first day.
Regarding procedures, you may be allowed to do a lot or not that much depending on your site. Typically students can perform the H&P and, if you've done OBGYN, the IUD removals and pap smears. On our first day, we are trained on how to do a few procedures including clipping ingrown nails, conducting punch biopsies, shave biopsies, expressing cysts, and administering intra-articular injections. Actually doing any of these will depend on the patient presentation and preceptors.
Presentations in Family Medicine tend to be more concise and focus more on assessment and plan, use the SNAPPS format
Portal Assignments
You will be asked to complete two portal responses which are basically to give you a chance to practice effectively responding to inbox/portal messages from patients.
The goal of the exercise is to adequately address all the patient's concerns and engage in shared decision making in a written format, they do not judge you on your clinical decision making skills.
This exercise shouldn't take more than ~30 minutes. If it does, you're overthinking it!
HIGHLY recommend having the rubric open while you're working on the response. Make sure to hit all the points on the rubric in order to get full points.
Your response may end up being longer than what you would expect for a portal message IRL, but I would recommend writing more and hitting all the rubric points than being too brief and missing points.
Key Points:
Respond within 1-2 business days (i.e. weekends don't count).
Engage in closed loop communication - recognize what the patient's asking for.
Be empathetic.
Provide opportunities for shared decision making- offer options that allow patients to choose what works best for them. Providing options also decreases the chance that they'll choose "none of the above" and be lost to follow up.
Make sure to include the terms "together," "reassure," and/or "confident." These are considered "soothing" words.
Include a list of next steps at the end of the message (kind of like a TLDR).
Include a list of instructions for your care team
"If the patient chooses x, then do y"
"If the patient doesn't respond in x days, please call them or their caretaker"
Presentation
The presentations are very casual, and you can choose your topic. It is usually helpful to choose a high yield topic or a topic you may find yourself struggling with on UWorld.
Warm and Wise Simulation
Review the rubric the night before your simulation.
Shelf Exam
The shelf exam consists of 110 multiple choice questions. You are only required to score above the 10th percentile to pass the clerkship.
Tier 1 → You should aim to do all of the UWORLD for Family Medicine - that should be your main goal. If you have extra time you can redo your missed questions or redo the entire bank again. If you do all of UWORLD and nothing else, you will be able to pass and do quite well. Everything beyond this that you can do is a bonus.
Tier 2 → Try to complete the practice NBME exams.
Tier 3 → If you have extra time you can complete the Family Medicine Aquifer cases and watch the Online Med Ed or Osmosis videos for the content you're struggling with before or during the rotation.
You can also check out the Mayo Rochester Clerkship Guide
*most important resources are in red that you should do at minimum to pass
UWORLD
You know where to find that!
Question bank is about 380 total questions
Do it all at least once!
NBME Practice Exams
USPSTF Guidelines
Aquifer Family Medicine Case Studies
Online MedEd or Osmosis
Check their respective websites for the videos.
Here is the Online MedEd PDF booklet that you can scan quickly for review.
Use this template and adjust to your own needs!
Print out a few copies and keep in your pocket
Great for annual physical visits
Pediatric Smart Phrases
FMCWCC12TO17YOFEMALE
FMCWCC12TO17YOMALE
FMCWCC15MO
FMCWCC18MO
FMCWCC1MO
FMCWCC2MO
FMCWCC2YEAR
FMCWCC30MO
FMCWCC3YR
FMCWCC4MO
FMCWCC4YO
FMCWCC5YO
FMCWCC6MO
FMCWCC6TO8YO
FMCWCC9MO
FMCWCC9TO11YO
FMCWCCNEWBORN
NHSPORTPHYSICAL
PEDSNEWBORN
ANTICIPATORYGUIDANCE
Pointers
Make sure to review the screening guidelines for your patients based on their age and gender. You can do this through the USPSTF app or Care Gaps on Epic. Preceptors want to know that you are thinking about preventive screenings even if the patient is presenting with a specific complaint.
AskMayoExpert is a very helpful resource and is the most up to date for Mayo Clinic-specific recommendations.
Eau Claire, WI (MCHS) Fam Med Notes - I. Abdulwadood
Misc:
Location: Clairemont Campus, 733 W Clairemont Ave, Eau Claire, WI 54701
Will spend all of your time in SET (student education team) clinic seeing patients with physicians and advanced practitioners (nurse practitioner, physician associate, etc.). The environment is very chill and supportive.
Attire: Business casual
Orientation takes up half of the first day – use this time to get used to layout, practice skills, and grab Epic Smartphrases. Feel free to shadow in the afternoon then start seeing patients on Day 2.
When you see a patient, you're expected to have diagnoses, orders, and a plan pended before you present. It doesn't have to be all correct, but they want to see you've been thinking.
Highly recommend working on putting in diagnoses and orders when you're pre-charting and while in the room with the patient. This is a little tricky at first, but you'll get the hang of it and it'll make you all the more efficient.
There are also occasionally PA and NP students helping out with SET clinic.
Schedule:
SET clinic everyday.
If you're interested in other aspects of primary care such as addiction medicine or primary care pharmacy, ask to shadow other clinicians in the practice!
First appointment is at 8 AM, last is scheduled for 4 PM.
Most students arrive around 7:30 AM and leave by 5:30 PM (or whenever you finish your notes for the day).
Daily morning didactics is at 8 AM with the SET team, then we start seeing patients around 8:30 AM.
I recommend arriving around 7:30 AM so you can read up on the first patients and be ready to see them as soon as didactics conclude.
Also a great time to work on inbasket patient messages.
Lunch:
There isn't a cafeteria or coffee shop in the building, so bring food and coffee, and feel free to use the breakroom to refrigerate and store your things.
There was almost never enough time to go off campus for lunch, but there are a few shops across the street such as Caribou Coffee, Starbucks, and Chipotle.
You do get $15 lunch vouchers, but since we don't have time to go to the main hospital cafeteria, just save them for another time.
Living:
Fly into MSP airport, get a rental car, drive to Eau Claire, WI (1 hr 30 min drive)
Eau Claire has the main grocery stores: Walmart, Target, Hy-vee, and now a Costco!
Students stay at Haymarket Landing. Pretty nice, modern building, also serves as dorms for University of Wisconsin - Eau Claire students.
Park at the North Barstow parking garage (less than 5 min walk away).
Near Phoenix park! Great to hangout and get some fresh air. They also have food trucks on the first Friday of every month and live music in the summer.
Apartments come with: washer/dryer, full kitchen with utensils and pots, bedsheets, pillow, and towels.
No access to the fitness center, you will have to purchase your own membership.
Work hard, Play harder:
DEFINITELY try deep fried cheese curds if you haven't already been introduced to the midwestern delicacy
Eau Claire Farmer's Market - literally everyone in town goes to the farmer's market in the summer
Highly recommend croissants from The Nostalgic Bean
Thai Orchid - unexpectedly great Thai food!
Olson's Ice Cream Eau Claire - same building as haymarket landing
Ramone's Ice Cream Parlor - decide for yourself if you're team Olson's or team Ramone's
Acoustic Cafe - good sandwiches
The Nucleus - breakfast/brunch
Local Coffee Shops:
ECDC - great coffee (though $$) and good study spot, walkable from Haymarket
SHIFT Cyclery & Coffee Bar - GREAT coffee and GREAT study spot, walkable from Haymarket
Racy D'Lenes Coffee Lounge - good study spot, attached to the Nucleas so you can have a coffee while waiting on brunch, longer walk
The Coffee Grounds
The Goat Coffee House - same shop that sells coffee in the Luther hospital building
Kahvi Coffee House + Cafe - good study spot, a bit of a drive away
Eau Claire Public Library - walking distance from Haymarket (and close to Ramone's)
Lowe's Creek - great for hiking, beware of ticks!
Restaurants I was recommended, but did not have time to visit:
Mona Lisa's Restaurant
Egg Roll Plus - take out only
The Informalist (near ECDC)
Mi Mi Cafe
Monk's Bar and Grill
Madden Ramen - same building as haymarket landing
Warm and Wise simulation
Portal Assignment 1
Portal Assignment 2
SMART Goals worksheet
Midclerkship Form
Log work hours in Medhub
Last updated in November 2024 by Vivian Shing