Northwestern University Feinberg School of Medicine
MD Education

Primary Care Clerkship

This required four-week clerkship is a brief but intensive introduction to the world of the primary care physician. Students will have the opportunity to work with physicians who practice the biopsychosocial, patient-centered philosophy that is central to primary care. During the four weeks, students will be exposed to the broad range of clinical problems encountered by family medicine and internal medicine physicians and gain a broader perspective on the role of medical care in people's lives.

Students will spend most of their time in one or two outpatient offices with a family medicine or internal medicine physician, working directly with an attending for an extended period. They will need to be efficient during these visits, as they’re often only 15 to 20 minutes and may cover more than one patient concern.

Hours are generally 8 a.m. to 6 p.m., Mondays to Fridays, though a few clinics ask their students to come for evening sessions and start later in the day.

Didactic sessions are held each Wednesday (typically from 8 a.m. to 4 p.m. or 7 a.m. to 3 p.m.) to supplement the clinical experiences. These are generally interactive, case-based discussions but also include lectures on disease prevention and web-based modules. As a clerkship requirement, students will also do a formal presentation on a topic of their choice for their peers.

 Goals & Objectives

Detailed Goals and Objectives

Find comprehensive Primary Care Clerkship Goals and Objectives.

 Grading & Evaluation

The breakdown of grading is:

Clinical performance40%
Weekly report25%
Exam20%
LCLG15%

Any clinical performance score less than 4 is sufficient to mandate a failure. Failure may also be linked to substandard LCLG projects, an exam score of less than 65% or a cumulative score less than 65. Students may also fail for professionalism issues such as dishonesty, unexcused absences or other inappropriate behavior.

For a high pass, scores must be greater than 80 with an exam score of at least 80%. For honors, scores must be greater than 83 with an exam score of at least 85%.

If you have a question about your grade, please reach out directly to the clerkship director.  

 Tools and Readings

Download the Clerkship Clerklog

Books

Goroll, Allan H., and Albert G. Mulley. Primary Care Medicine: Office Evaluation and Management of the Adult Patient. Philadelphia: Wolters Kluwer Health, 2014.

  • This book has a problem-oriented organization addressing adult medicine.

Dornbrand, Laurie. Manual of Clinical Problems in Adult Ambulatory Care: With Annoted Key References. Philadelphia: Lippincott Raven, 1997.

  • This manual is the ambulatory equivalent of the Wash U. manual. An excellent quick reference for the office setting. The annotated references are of particular help.

Required Readings

Clinical preventive medicine

  • Goroll Chapter 3 (p. 18)
  • Guide to Clinical Preventive Services: Report of the U.S. Preventive Services Task Force. A brief introduction to the Task Force approach is followed by representative tables from the report. (Tab 1)

Common psychiatric problems in primary care

  • Goroll Chapter 230 (p. 1371)
  • Barsky, Arthur J. A 37 Year-Old Man with Multiple Somatic Complaints: Clinical Crossroads. JAMA 1997;278:673-679. (Tab 9)
  • Quill TE. Somatization disorder: one of medicine's blind spots. JAMA 1985;254:3075-3079. (Tab 9)

Fatigue

  • Goroll Chapter 8 (p. 47)

Headaches

  • Goroll Chapter 165 (p. 1077)

Health Maintenance and Screening

  • Goroll Chapter 3 (p. 18)

Hyperlipidemia

  • Goroll Chapter 27 (p. 190)
  • Gorroll Chapter 15 (p. 96)
  • Drugs for Lipids. Treatment Guidelines for The Medical Letter. Vol. 3 (Issue 31), March 2005. (Tab 7)
  • Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) JAMA 2001;285:2486-2497. (Tab 8)
  • Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. (Tab 8)

Hypertension

  • Goroll Chapter 14 (p. 93)
  • Goroll Chapter 19 (p. 117)
  • Goroll Chapter 26 (p. 175)
  • Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (Dash) diet. NEJM 2001; Vol 344: Number 1, January 4, 2001. (Tab 6)

Immunizations in adults

  • Goroll Chapter 6 (p. 27)

Irritable Bowel Syndrome

  • Goroll Chapter 74 (p. 552)

Low Back Pain

  • Goroll Chapter 147 (p. 955)

Pharyngitis

  • Goroll Chapter 220 (p. 1310)

Sexually Transmitted Diseases

  • Drugs for Sexually Transmitted Diseases. Treatment Guidelines from The Medical Letter Vol. 2 (Issue 26) – October, 2004.

Sinusitis

  • Goroll Chapter 219 (p. 1306)

Smoking cessation

  • Identification and Assessment of Tobacco Use. Treating Tobacco Use and Dependence: Quick Reference Guide for Clinicians. October 2000. U.S. Public Health Service (Tab 10)

Scope of primary care

  • Hughes JS. Medical art and medical science: an exhortation to students on primary care. J Gen Intern Med 1989;4:48-53. (Tab 3)

Thyroid Disease

  • Goroll Chapter 95 (p. 685)
  • Goroll Chapter 103 (p. 735)
  • Goroll Chapter 104 (p. 745)

Urinary Tract Infection

  • Goroll Chapter 133 (p. 883)

Vaginitis

  • Goroll Chapter 117 (p. 801)

 Frequently Asked Questions

What are the daily expectations for a M3 on this clerkship?

Students will be seeing patients almost exclusively in an outpatient setting.  They will need to be efficient as often the entire visit is 15 to 20 minutes and patients may have more than one concern.  They will be doing multiple succinct bedside presentations daily.  They need to focus on the assessment and plan. 

What is the typical schedule (number of days worked/hours per day) for this clerkship?

Monday through Friday, generally 8 a.m to 6 p.m., however a few clinics have the students come for evening sessions and start later in the day.  Wednesdays are purely didactic and are from 8 a.m. to 4 p.m. or 7 a.m. to 3 p.m.

What is pre-rounding? Rounding? Note writing expectations for this particular clerkship?

N/A for PCC however the student should review the clinic schedule for the upcoming clinic ahead of time either by getting to the clinic early and/ or even remotely from home.  They also should review labs/tests they ordered on patients they saw in the previous session.  They should be prepared to write SOAP notes on acute problems and how to write up a patient with chronic medical problems.

What does “Call” mean on this particular clerkship?

No call

What do I do if I have a question about my clerkship grade?

If you have a question about your clerkships grade you should discuss this directly with the clerkship director.  

What do I do if I have experienced or witnessed Student Mistreatment during this clerkship?

If you have experienced or witnessed student mistreatment, there are many avenues to report this.  You can discuss this with the clerkships director, mentor, any of the deans or Lisa Rone, MD, the ombudsperson. 

What do I do if I feel burnt out or overwhelmed during this clerkship?

If you feel burnt out or overwhelmed during a clerkship there are a number of people you can speak with. The clerkship director, your mentor or anyone in the dean’s office are available to talk. CAPS can also be extremely helpful in this situation.  You can contact CAPS at 847-491-2151.

Who do I contact if I am sick or have a personal appointment?

Contact the Clerkship Director, clerkship coordinator and preceptor. They need to let all three know.

Appointment: should ideally ask prior to the start of the clerkship or at least inform us of the appointment or plans for an appointment and we can help guide a time that is least to interfere with patient care activities.  But if not to let the Clerkship Director and clerkship coordinator know and we would let their preceptor know.

Any required equipment?

Stethoscope.

Contacts

Jennifer Bierman, MD
Director

Ashley Barnes
Coordinator
Phone: 312-926-7251
Fax: 312-926-6905

Family Medicine Faculty

Mark Macumber, MD

Nisha Patel, MD