Contact Info from the Lunch Panel

Thanks so much for coming to FMIG's "What is Family Medicine Panel?" this past Tuesday! We had a great turnout and were really happy to see a mix of both years. To those of you who weren't able to make it but wanted to, please keep your eyes open for upcoming FMIG events.

Also, we received some great questions about Family Medicine from your feedback evaluations. We will write a whole separate post to answer as many as we can, so keep visiting the blog!

Here are the email addresses of our panelists from Tuesday who all agreed that they would be happy to respond to questions you might have:

• Dr. Markuns (International Health interests)- Jeffrey.Markuns@bmc.org
• Dr. Green (Sports Medicine interests)- Alysia.Green@bmc.org
• Dr. O'Brien (Ob-Gyn/Rural health interests)- michlynn@bu.edu or Michelle.OBrien@bmc.org
• Anthony Lim (BUSM IV) - alim@bu.edu
• Christopher Simons (BUSM IV)- simonsch@bu.edu

Finally, for those of you who approached Dr. Markuns after the panel and were interested in possible international health opportunities, he has kindly provided the following contact:

LeBoHA program
Libby Cunningham is the Program Coordinator (ecunning@bu.edu)
Dr.Markuns also mentioned that students should feel free to contact him directly with further questions.

Sports Medicine Workshop series!

Many of you met Dr. Alysia Green at our panel this past Monday. As you heard, Dr. Green is one of four BUMC family medicine faculty fellowship-trained in sports medicine. This year, she will continue the very successful series of FMIG Sports Medicine Workshops that started last year. Thanks, Dr. Green!

This year's workshops will all take place on Thursday evenings, 5:30-7:30pm. Because the workshops teach hands-on skills, each workshop will be limited the first 20 students to sign up. Emails will be sent out in advance of each workshop with specific RSVP links. For those who like to plan ahead, check out the FMIG Events calendar at the top right corner of this page to see all upcoming Sports Medicine Workshop dates and topics.

*** The first workshop is next THURSDAY 8/27. Dr. Green will introduce Sports Medicine, in the context of Family Medicine, and will teach spine boarding! ***

Donna (MS2, kurowski[at]bu.edu) works closely with Dr. Green to plan these workshops throughout the year. Email her if you have any questions!

Reminder about AAFP

Remember, as students we get FREE membership to the American Academy of Family Physicians, which includes a FREE subscription to the American Family Physician Journal, a great resource even before our clerkships. Sign up for membership online!

What is Family Medicine? Lunch Panel TOMORROW!

Come to our first event of the year!

• Who: Everyone
• What: What is Family Medicine? Hear from family physicians and a 4th year student applying to family med residencies.
• When: Tuesday (8/18) 11:30am-12:30pm
• Where: L-110
• Why: Learn about the full scope of practice in family medicine, meet first and second years, and eat free PIZZA! (Hint: always better to come early when there's free food...)

Check back here next week for a recap and some photos of the event...

Back to School

To all the first year students: Welcome to BUSM! Thanks for stopping by our table at the student organizations fair last week. We enjoyed talking to all of you and sharing about family medicine and FMIG. And to the second year students: Don't forget to take the DRx quiz tonight. And welcome back!

Some of the FMIG leaders: Donna, Neetu, Lucas, and Jessica
(Not pictured: Carly, Caitlin, Erkeda)

While the first years are acquainting themselves with BUSM and each other, the second years hit the ground running with the first block of the Disease and Therapy course. But even with lectures galore, we at FMIG are working hard to plan a great year of events and opportunities for you.

Last Thursday, a group of second year students including many of the FMIG leaders volunteered at a health fair hosted by the Codman Square Health Center, a popular CCHERS site. We took blood pressures, spoke with teenagers from the community who helped to run part of the fair, and generally helped out where we could.

Volunteering at the Codman Square Health Center

Carly also discovered that many of the teens there were part of an awesome local organization called BOLD Teens committed to improving the quality of life in their Dorchester neighborhood. It was pretty cool to hear about what that group has accomplished over the years, and to see the investment and involvement they have in their community. I have to admit that I have not explored Boston enough yet, nor spent enough time in some of Boston's neighborhoods. Many of the family medicine faculty at BMC have their clinics at community health centers, and so much of their practice is getting to know the residents of that community. I hope we all have more chances this year to venture beyond the BUSM bubble!

Messages about NC09 from a newbie

So it was my first National Conference. and i LOVED it!
As someone who was interested in FM, and now even more so, I think it was a great way to meet folks with similar questions, ideas for career paths, as well as folks with different ideas that I didn't think could/would work but clearly can in FM!
The residency fair was amazing, and a bit overwhelming, but since it's FM, everyone was super nice, friendly and supportive of what I was interested in even if it was not what their school offered. As an MS3 going to the residency fair, it was helpful in sorting out which programs I wanted to try to contact for possible sub-i's, and which programs I could spend more time researching. The fair also gave a good idea of what the people are like at that residency program. The diversity, the mentality, the focus, the spirit-if you will-of the programs.
Plus one gets to tote home a boatload of goodies: brochures, pens, gadgets, bandaids, stressballs etc and most importantly, contact info!

The workshops are also quite good: useful and applicable even if you are not necessarily interested in FM. I attended the Wilderness Medicine (sponsored by our friends up in Central Maine--they're awesome!!!), Dermatology, Maternal/Childbirth/OB, Applying to Residency workshops. All were helpful in dispelling some myths, providing more ideas, and all in all being useful info to have.

Last thing: Midwest airlines has a hub through Milwaukee. BUT, they serve 2 fresh baked, piping hot chocolate chip cookies on every flight! And the Aladdin hotel (Holiday Inn) rocks the champaigne and the retro-cool and definitely wins in terms of hotels.

Tips for next year (MS4): stay the whole time, bring business cards, CV, personal statement, nicer outfit, and your best smile.

Congress of Students and Continuity of Care

At the beginning of July, I was recruited to serve as a member on a Reference Committee and began my journey in the Student Congress world of the National Conference. Concurrent to the workshops and exhibits, 50 delegates (from each state) and other interested students convened in the AAFP student government/congress Thursday thru Saturday. The congress serves two purposes: to write resolutions and to elect student leaders. I will speak here about the resolution writing process.

In the first session, a brief overview of the resolution writing process was discussed followed by discussion groups based on topic. I attended the education/career planning discussion group because one of the issues I am passionate about is continuity of care education opportunities in medical school. Looking at my school's clinical curriculum, I lament the fact that there are no continuity experiences available to students. We spend between 4-6 weeks at each site and at most see patients twice. I think that continuity experiences would allow medical students to realize the value of primary care and I spent much of my first few weeks in clerkship dreaming about a weekly continuity clinic and decided I would submit a resolution on this issues.

My resolution is as follows:

"Medical Education Continuity of Care Curriculum Recommendations 

Whereas continuity of care is an esteemed value of the practice of family medicine, and 

Whereas early exposure to continuity of care experiences during medical school may increase interest and awareness of family medicine as a potential career choice, and 

Whereas continuity of care is beneficial to patients and enhances health outcomes, be it 

Resolved, that the American Academy of Family Physicians recommend to the Council of Academic Family Medicine to explore creating curriculum recommendations to incorporate a longitudinal continuity of care experience throughout medical school such as a 4-year weekly continuity clinic."

After submitting the resolution, it went to a reference committee. Reference committees listen to testimony about the resolutions from authors and other interested parties, study proposed resolutions and provide recommendations to the congress for adoption of resolutions. They function to reduce the time needed in congress. As such, congress reviews the recommendations of reference committees and only opens individual resolutions when requested. 

In addition to submitting a resolution, I also served as a reference committee member for the first time. In this position, I listened to testimony about resolutions, reviewed the resolutions with the rest of the committee and made recommendations for the congress. It was very encouraging to see that medical students were very engaged and passionate about issues surrounding family medicine. Proposed resolutions ranged from developing sleep disorder curricula to health care reform position proposals to changes in web design in the AAFP website.

This was my first time participating in the parliamentary procedure to pass resolutions and elect student officers. I thought that it was a very enlightening experience! Also, my resolution was passed both by the reference committee and in congress, and will make its way to the Council of Academic Family Medicine (composed of FM dept chairs) where hopefully they will develop curricular recommendations and guidelines for longitudinal continuity experiences!

Massages from the AAFP

Jessica Chi (BUSM II, FMIG Leader) gets ready for her next blog at NC.

After several hours of residency booths, workshops, keynotes, and more, it's time to pay attention to our aching bodies. That's when we head to Booth #303 aka the "Comfort Station." To the four local massage therapists: my trapezius and rhomboids thank you. It's good for the healers to be healed every now and again!

Let your voice be heard! - Advocacy in Family Medicine

The afternoon session I attended today was a health advocacy open forum where students and residents discussed any advocacy they had been involved with and provided suggestions for getting started for those of us (myself included) yet to have any experience in this area.

One student said she had never really been excited about advocacy until she stepped back and looked at the big picture of how many people she could reach with her actions. She also reminded us not to be intimidated by people at your elected representative's office and to recognize the value of speaking with the staff there even if you can't speak to your senator or congressperson.

One of the residents explained his theory of advocacy through research; performing research with the intention to change policy or viewpoints on a particular subject with your outcomes. He also reminded us that advocacy was all about "making noise" wherever you can, whether it is presenting your research results to the local news station, writing a letter to the editor of your local newspaper or serving on a committee of the AAFP, AMSA etc.

Another student reminded us that we all already advocate for our patients everyday, and that taking the next step to advocate for groups of patients is not too big a step for a student. Taking a leadership role in your local chapter of the AAFP might be a good first step or coming to the national conference and participating in the business sessions.

Another resident provided some helpful advice for getting started, including: find an organization whose "voice" you agree with and start showing up to meetings, don't be afraid to take on tasks and make your voice heard when asked, and be on the look out for people who come into your life and inspire you to change your vision or goals.

My thought it that, as physicians, we are going to be looked upon as leaders whether we like it or not, so it behooves us to be prepared with the knowledge (and hopefully practice) of how to advocate for change when it is necessary.

A little bit about me:
I am a 4th year at BUSM applying in family medicine this year. I was one of the co-leaders of the FMIG during my second year and have been a FaMeS member since 1st year. I am currently the student director sitting on the Massachusetts Academy of Family Physicians' Board of Directors.

If anyone out there is looking for more information about how to get involved either at the state or national level with the AAFP, please email me at simonsch@bu.edu

Ready to Start School Again...

Blogging live from... seat 11A. Did you know that Airtran offers wifi ON THE PLANE?! Luckily, I grabbed a few free trial vouchers on my way into Kansas City so that I could blog on my flight back home to Boston.


The conference has officially ended by now, though I had to miss most of the last day due to an earlier flight. I have to admit that I did not have many expectations when I first arrived in Kansas City just a couple days ago, largely because I was still enjoying my Last Summer Vacation too much to think about medical school stuff. Now, I am so glad I went to AAFP's National Conference right before starting second year. The gears in my head are creaking back to life, and I couldn't help but send out a few emails to my fellow FMIG leaders to share the excitement!

(Excitement about FMIG, not about the upcoming exams every three weeks during second year.)

I learned so much more about what it means to be a family physician this week. And I would write more, but it's landing time at Logan!

UJC (Ultimate Journal Club)

This afternoon's "Ultimate Journal Club" was run by journal heavyweight Dr. Kurt Stange, current editor of the Annals of Family Medicine. In addition to broad discussions on running effective journal clubs and publishing research articles, we discussed his recent article, "The generalist approach" (2009), which describes the qualities of a generalist physician that are suited to meet the needs of our fragmented health system (Stange, 2009).

In the article, Dr. Stange narrates a patient story in which issues of transition of care, physician-patient relationship, and continuity of care significantly impact the life (and health) of a person in his care. He notes that the generalist is uniquely able to address these issues, and is distinguished by the following characteristics (among others):

• Humility
• Openness to diversity
• Broad knowledge base (i.e. self, family, systems, interconnectedness)
• Can see the forest through the trees
• Constant scanning and prioritizing
• Integrating & connecting
  

These characteristics act as a wrapper around the evidence-based medical practices that are part of the daily work of all physicians. Yet, while they are often undervalued, these principles of the generalist are the keys to solving issues in health care today.

The Ultimate Journal Club was yet another forum in which was highlighted the unique ability of Family Medicine Physicians to address the needs of the current crisis in health care. These same characteristics were repeated in the morning keynote by Dr. Robert Graham who clearly outlined how Family Medicine principles can help improve the cost, access, and quality of health care.

So...it seems like Family Medicine is integral to the future of medicine. Med. students, pay attention. The wind is shifting (almost daily on Capitol Hill) and we've got to be prepared for where we end up.

References

• Stange. The generalist approach. The Annals of Family Medicine (2009) vol. 7 (3) pp. 198-203
• Stange. The Problem of Fragmentation and the Need for Integrative Solutions. The Annals of Family Medicine (2009) vol. 7 (2) pp. 100-103
  

"Lub dub" and so much more - Heart Sounds Workshop

This afternoon I went to a heart sounds workshop put on by The Toledo Hospital. We used an awesome program called CardioSim that broadcasts heart sounds over a wireless network to these headsets (see pictures.) We started with the basics - which side of the stethoscope to use for which sounds, where to listen, how each heart sound is made, etc. Moving on to murmurs we got to see CardioSim in full action, listening to each murmur with and without lung sounds, at varying intensity levels, and with and without prompted visual cues of the sounds on the screen. We ended with a closed eyes "final exam" and a raffle for a Littman stethoscope.


It was the perfect review for medical students, starting at a slow pace and building to practice with critical skills that we will use everyday. These talks are one of many reasons I love coming to these conferences!!

Andrea Rier, BUSM IV
Future Family Physician

Exposition Hall = Games, Prizes, and...oh yeah...Residency Programs

Center for the History of Family Medicine (Booth#1010)

Like many conferences, the AAFP NC has an exposition hall that's filled with a constant hum of "shmoozing" conversations, the flash of cheap give-away gadgets, and, every once-in-awhile, a jewel. Booth 1010 is one such jewel. The Center for the History of Family Medicine's booth does not seem to get much action, but something from their table catches my eye. I walk closer and discover the shiny objects in the picture below.

Past & Present Tools of the Trade

After some time gazing at these historical instruments and chatting with the CHFM's representative, I discovered that there is a rich history of how Family Medicine got to be where it is today - poised to become a unique source of quality primary health care - and there are people actively working to document and preserve that shared story of our profession.

If you want to better understand the future of Family Medicine by better knowing its past, explore the Center for the History of Family Medicine's website. Answer questions like...

• When the first Family Medicine Residency program was introduced to Massachusetts?
• Why is Dr. John Willis considered to be the "Grandfather of Family Practice"?
• How old is the specialty of "Family Medicine?

...and once we know where we've been, what's been tried before, what's succeeded and what hasn't, then we will be best suited to face the uncertainty of the future practice of medicine in the United States of America.

Oh...and if you can guess what the instruments were used for, you get a prize! On to the next booth!!

Best FMIG practices

BUSM FMIG won a categorical Program of Excellence award in Promoting the Value of Primary Care this year! We received our certificate this morning at the FMIG breakfast, and now Marcel and Jen are about to give a brief presentation on what our best practices were. Other FMIG Program of Excellence Award winners will share their best practices too.

I'm going to try to blog live, macworld style.

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Edit: if you are actually following this live, refresh the page often.
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9:37am Oregon Health and Science University is presenting their Baby Beeper program. It sounds pretty cool. Basically, first and second year students get an opportunity to see prenatal and maternity care through the lens of family medicine. Students go to at least one pre-natal visit to meet the mother, and family medicine residents call/beep students when the mother goes into labor. Residents also try to schedule post-natal visits with the students. Needs: a dedicated student coordinator, must establish buy-in from residents and L&D nurses.

9:43am Clarification, beepers are out of style and could be more impersonal. Residents and students exchanged cell phone numbers. Another program OHSU started this year was the "No One Dies Alone" program: students sit with terminally ill patients in the hospital to be there for them.

9:45am Pennsylvania State University won the Program of Excellence Award in Exposure to Family Medicine & Family Physicians. They organized a series of residency dinners wherein FM residents from different programs in the area treated students to dinner in the city to discuss any one of a list of topics that students were interested in.

9:48am Residents in Hershey PA willingly treated students for this dinner series... do you think the Boston residents are up for that?

9:52am University of Nebraska is describing highlights from their procedure night workshops. 3-4 FM residents teach 30-40 students how to do a particular procedure: casting, suturing, lumbar puncture, airways and intubation, ABG's and IV's, elbow injections and lung sounds. Sounds very similar to BUSM FMIG's sports medicine workshop series. Donna Kurowski (MS2) is heading that up this year, so keep an eye out for her emails.

9:56am Sebastian is introducing BUSM FMIG! Marcel and Jen are up...

9:58am We tackled the challenge of making primary care sexy by strengthening the FM community and by highlighting the diversity of family medicine practice. The latter was especially emphasized during last year's National Primary Care Week. I hope we can have another active NPCW this year, want to help plan events?

10:00am NPCW is a great event to co-sponsor with many potential partners on campus. Working together also brings in many students including students who may not necessarily be interested in FM.

10:01am I see Sebastian taking photos from the front, so you'll see pictures here soon.

10:02am New things for our FMIG last year: newsletter "All in the Family", blog, social events. Marcel just gave me a shoutout in the back as one of the contributing bloggers. Little does he know that I am live blogging their talk.

10:03am Ok never mind, he does know. Nice, there's a wordle of blog posts up on the powerpoint. 60 blog posts! 800+ visitors to the blog!

10:07am Meharry Medical College won the Program of Excellence Award in Community Service, Special Consideration Award for First-time Applicant. Some improvements that they implemented this year: paid dues for members to encourage commitment, really cool FMIG shirts ($5 each! Must get on that), text reminders about meetings and events.

10:10am Meharry's Project R.E.C.E.S.S. was featured in the Tennessee Academy of Family Physician's Journal (didn't catch the acronym). The project focused on smoking prevention at a local elementary school because the Tar Wars program couldn't get started in time. The featured booths: Gasping for Air activity, Jar of Tar illustration, Hazards & Effects of Smoking which was a black lung model and display board. The prizes were all active toys, such as kites, promoting active lifestyles-- what a great idea!

10:16am Who's up for starting a Tar Wars program in Boston?

10:18am And it's all over. Onto the Exposition Hall!

Main Stage Lecture: Stephanie Vance, Advocacy Guru

How can we be most effective as citizens going to DC to advocate for health care reform?

We have to bring our personal stories to leaders of the country. We have the day-to-day experiences that we can bring to the table. We already advocate every day for our patients - we should take that to the next level: the state and then the federal government.

Her main points:

Many people in the audience seem to think that our government is broken. Only 4% of bills introduced are passed. Of those that pass ~ 33% are about renaming post offices and federal buildings. The founding fathers of this nation had set up a system with many checks and balances that does not work efficiently. The system was designed to work this way.

Money talks in Washington DC! But constituency also matters. Legislators want to know how you are involved with their constituents. The 14-year-old who picks up the phone still knows how to figure out your relation to constituents but doesn't know how much money you have donated. If we want to be active in the health care debate, you need to know how you are related to each individual legislator. Otherwise, honestly, they won't pay much attention to you.

Reading the bill is not the important part. Understanding the impact of the bill will make a big difference.

The August district work period is an essential time for contacting your legislators. They will be back in their local offices to do work during this period and it will be a great time to contact them.

Key message: Be Very Clear About What You Want!