The Clerkship in Family Medicine is a required four-week clinical rotation for third-year medical students designed and administered by the Department of Family Medicine at the Indiana University School of Medicine.

Core Diagnosis

Frequently Asked Questions

Goals and Objectives

Grading Policy and Evaluation

Site Director and Student Coordinator Information

Course Description

Preceptor Manual

Textbook

Core Diagnosis

Frequently Asked Questions
Q: Do I have to blue chip Family Medicine if I want Indianapolis.
A: Yes. Indianapolis is a very popular site and always fills up before all students are assigned. Blue-chipping Family Medicine DOES NOT GUARANTEE you will receive your 1st, 2nd, or even 3rd choice. When too many students request one specific site, the students are selected with a lottery system.

Q: I have small children and need to stay in Indianapolis for my Family Medicine rotation. What should I do?
A: First, you will need to use your blue chip. Second, you need to attach a letter to the clerkship director explaining why you need to stay in Indianapolis or any other selected site.

Q: I have a disability that requires me to stay in Indianapolis. What should I do?
A: This situation applies the same as having small children. You must use your blue chip to stay in Indianapolis. You must also attach a note to your request stating your reasoning for needing Indianapolis.

Q: My wife is pregnant and due during my rotation. Can you assign me to Indianapolis?
A: This situation applies the same as having small children. If you or your spouse is pregnant and due near the time of the Family Medicine clerkship, you should blue chip Family Medicine and write a letter to the clerkship director explaining the situation.

Q: I didn’t fully complete my site preference form. What will happen with my assignment?
A: If you are not selected for the site you requested, your preference form will be placed at the bottom of the stack REGARDLESS of your blue chip. You will be assigned to the last spot available.

Q: Where do I report on the first day of the clerkship?
A: Most sites have an orientation on the first day of the clerkship. If you do not receive a letter explaining when and where to report on the first day, you should contact your student coordinator at your assigned site. Click here to review site contact list.

Q: My family physician has agreed to be my preceptor. What does he need to do to receive clerkship materials?
A: Students may not make their own assignments for the clerkship. However, if there is a physician you would like to rotate with during the Family Medicine Clerkship, you will be provided an opportunity to request that preceptor. The preceptor must be approved by the department and site. Preceptors MUST be board-certified (or board-eligible) family physicians.

Q: I have not been assigned to the site I requested. Can I be reassigned to the site requested?
A: All sites must have an equal amount of students. We will not move students unless a student is dropped or added to the rotation. Students are welcome to call and request to be added to the wait list for that rotation. Students must speak to the clerkship coordinator to make this request. Requests are honored on a first-come, first served basis.

Q: I have not been assigned to the site I requested. Can I be reassigned if I find my own preceptor?
A: No. Students should not seek their own preceptors or contact sites to be added. All site assignments are completed by the clerkship coordinator at the Department of Family Medicine.

Q: Whom do I call if I am having difficulties with my preceptor?
A: Your first step is to notify the site director. While preceptor conflicts do not happen often, there are times when students should be reassigned. Your site director will help facilitate this process. However, he/she can only do this if you let them know there is a problem. Sometimes the site director only needs to relay to the preceptor the problem and the situation is resolved. If you are not satisfied with the site director’s attention to this problem, you should contact the clerkship director immediately. We want to make this experience positive for both you and the preceptor. The clerkship director will work with all parties to resolve the issue.

Q: I received a card in my mailbox regarding the exam. What does it mean? Did I pass?
A: Sometimes it takes preceptors and site directors some time to return the evaluations on students. We like to inform students of the exam scores so you have some feedback. The score listed is your final score on the exam. We also provide you with the highest and lowest grades, as well as a mean score. The lowest passing score for the exam is 60. Students receiving a grade lower than 60 will be contacted by the student coordinator to schedule remedial work.

Q: When will I receive my final grade and comments?
A: While we make every effort to submit final evaluations within 30 days from the end of the clerkship, sometimes preceptors and site directors do not send forms in a timely manner. We continue to work on this situation and will submit all evaluations for any given rotation at the same time.

Q: What my preceptor told me was different than what was reflected in my evaluation. May I review his evaluation of my performance?
A: Yes. Students should call the student coordinator or the administrative secretary to copy the evaluation forms. Students must come to the office to pick up the evaluations. You may be asked to present picture ID. Keep in mind that preceptors do not determine the final grade. Your exam will count for 25% of your final grade.

Q: I have reviewed my evaluation and disagree with my grade. Who do I call?
A: Your first step is to call the clerkship coordinator. The coordinator will review your score and give you the cut off for specific grades. If you still disagree with your grade, the coordinator can set up an appointment with the clerkship director. The clerkship director will review the file prior to the appointment. If necessary, she will contact the preceptor and/or site director to request further feedback.
back to top

Goals and Objectives
Goal 1: The student will develop a primary care evidence-based approach to the diagnosis and management of problems commonly seen in community-based Family Medicine.

1. Demonstrate increasing knowledge of the 40 problems commonly seen in family medicine with emphasis on the Core Topics (page 14).
2. Demonstrate consistent application of relevant current, evidence-based when possible, literature at the “point of care” to determine patient management.
3. Consistently develop reasonable diagnoses and management plans for both undifferentiated and common medical problems.
4. Consistently demonstrate intuitive reasoning which supports diagnoses and management decisions.
5. Recognize serious and life-threatening patient presentations which require immediate intervention and demonstrate an appropriate clinical response.

Goal 2: The student will develop and refine clinical skills which are essential to the practice of competent Family Medicine as well as medicine in general.

1. Demonstrate increasing skill in the appropriate performance of focused versus comprehensive histories and physical exams.
2. Demonstrate increasing interpersonal and communication skills which facilitate accurate, pertinent and appropriately comprehensive information gathering.
3. Consistently demonstrate increasingly correct physical exam techniques and reproducible physical exam findings.
4. Document patient visits in the SOAP format with increasing organization and attention to pertinent information.
5. Observe common office procedures and whenever possible demonstrate increasing skill in procedure performance.

Goal 3: The student will understand the specialty of Family Medicine and its role within the healthcare delivery system.

1. Consistently demonstrate increasing integration of clinical and biopsychosocial information to achieve patient centered care.
2. Identify, discuss and when possible demonstrate the benefits and barriers to providing continuity of care.
3. Discuss and when possible demonstrate the impact of whole patient and whole family care on patient health outcomes.
4. Consistently demonstrate effective coordination of care with medical consultants, health professional services and community resources.

Goal 4: The student will develop knowledge and skills regarding the principles and clinical application of health promotion, disease prevention and patient education.

1. Demonstrate progressive integration of health promotion and disease prevention strategies into all patient visits.
2. Consistently identify health risk factors and demonstrate use of motivational interviewing techniques to identify and develop strategies for change.
3. Consistently identify appropriate patient education materials and activities, and demonstrate integration of these into patient care.

Goal 5: The student will understand the relevance of biopsychosocial, familial, socioeconomic and community factors to providing patient-centered whole person and whole family care.

1. Accurately identify and discuss the family, support system, community, cultural, ethnic, religious, occupational and economic factors influencing patient management and outcomes.
2. Demonstrate increasing integration of this above biopsychosocial information into patient care in a manner which will improve patient outcomes.
3. Demonstrate correct use of an interpreter in practices where this is possible.

Goal 6: The student will gain understanding of medical practice as both a profession and a business.

1. Demonstrate consistent responsibility for one’s own learning through timeliness, preparation, initiative in patient care, initiative in information gathering and response to feedback.
2. Consistently demonstrate compassion and understanding toward patients and their families, especially those who are disenfranchised or disadvantaged.
3. Consistently demonstrate increasing interpersonal and communication skills which facilitate peer, faculty and ancillary staff relationships.
4. Identify and discuss practice factors which affect efficiency, patient outcomes and office team functioning in both positive and negative ways.
5. Identify and discuss external factors which impact practice operations.
   back to top

Grading Policy and Evaluation
Grading Policy

Final grades are determined by several indicators of student performance on the Family Medicine Clerkship: 1) the Preceptor Evaluation; 2) the Didactic and Project Evaluation; 3) the Written Examination; and 4) appropriate and full completion of ALL assignments/requirements. The preceptor does not assign the student’s final grade! Specific criteria for Honors, High Pass, Pass and Fail in Family Medicine are described below (Mechanics of Student Evaluation).

Preceptor Evaluation: The preceptor will complete an objective, competency-based evaluation designed to measure specific knowledge, skills and attitudes. (Sample provided on pages 21-24.) Written comments offered by the preceptor will be paraphrased on the final IU SM Clinical Performance Evaluation form. If a student is evaluated poorly on any area of the preceptor evaluation form, the student’s overall clerkship performance will be reviewed by the clerkship director to determine the appropriate course of action. Redress may include remediation in specific content, repetition of all or part of the clerkship, or assignment of a grade of “Fail”.

Didactic Project Evaluation: The faculty at the residency program will complete an objective evaluation of the student’s overall performance and participation in didactic day activities, the Breaking Barriers in Healthcare modules, the Family and Community Project and procedure sessions. If a student is evaluated poorly on any area of the didactic project evaluation form, the student’s overall clerkship performance will be reviewed by the clerkship director to determine the appropriate course of action. Redress may include remediation in specific content, repetition of all or part of the clerkship, or assignment of a grade of “Fail”.

Written Examination: All students will take a comprehensive multiple-choice examination designed to measure knowledge of medical diagnoses and complaints seen in the family physician’s office. The examination questions will be chosen from a question bank for the Clerkship textbook, Essentials of Family Medicine. Questions will be selected to focus on the Core Diagnoses (page 14) and evaluate the Clerkship Goals and Objectives (page 2-3). The examination will be administered in Indianapolis on the final day of the clerkship.

We recognize that not all aspects of Family Medicine will be covered during the four didactic day sessions. Thus, the student is advised to read the Essentials of Family Medicine and utilize the Point of Care resources.

Students scoring less than Pass on the written exam must re-take the exam (page 19). In the event that a student fails the re-take, the student will fail the Family Medicine Clerkship. This will necessitate repeating the Clerkship. Students who retake the exam may not receive a grade higher than “Pass.”

Evaluation and Competency Comments: Late or unsatisfactory completion of assignments/requirements may be noted in the Comments section of the student’s final evaluation and on the Competency Evaluation. Omission of or unsatisfactory participation in Intersession activities may be noted in the student’s Competency Evaluation.

ID9, Professionalism and Role Recognition: Students are expected to complete assignments on time. Students exhibiting consistently late or unsatisfactory completion of assignments/requirements may receive an ID9.

The Department of Family Medicine is following the Clerkship Exam Policy approved by the Indiana University School of Medicine Curriculum Council. The following excerpts have been included for the students’ information. A complete copy of the policy has been included on the Angel website in the Family Medicine Clerkship Course Link at https://daly.medicine.iu.edu.

Student Irregularities

Student should be informed at the time of the exam and in writing that they are suspected of an irregularity/cheating and will be investigated.

• Inform student at end of exam.
• Student allowed to complete exam with grade pending outcome of investigation.
• Student will receive written notification of investigation; copy will be sent to appropriate Competency Director; copy will be placed into student’s file.

Student Tardiness

• If less than 30 minutes late, student may be admitted to exam but will have only the time remaining.
• If greater than 30 minutes late, student will need to reschedule examination.
• If valid excuse, no penalty assigned.
• If non-valid excuse, student penalized by having maximum grade on final exam portion of grade be a PASS.
• Determination of valid or non-valid is at the discretion of the Clerkship Director.

Student Absence

• Student with “valid excuse” will be permitted to take exam without penalty to grade.
• Student with “non-valid” excuse will be penalized by having maximum grade on final exam portion of grade be a PASS.”

Mechanics of Student Evaluation Calculation

The Family Medicine Clerkship grading policy is designed to include both criterion based (competency grading) and normative based (curve grading) information. An acceptable grade distribution for the entire class is 15-20% Honors, 30-50 % High Pass, 40-60 % Pass and less than 3% fail. Three components are utilized to calculate an overall clerkship grade:

• Preceptor evaluation (40% of overall score)
• Didactic / Project evaluation (25% of overall score)
• Written Exam (35% of overall score)

Each component is scored by the appropriate faculty and points are assigned based on the contents of each evaluation form.

Grade of Honors requires:

• Overall score percentage in the highest 20% of the rotation
• Honors scoring on two of three components
• Completion / Passing all clerkship requirements

Grade of High Pass requires:

• Overall score percentage in the highest 55% of the rotation
• High Pass on two of three components
• Completion/Passing all clerkship requirements

Grade of Pass requires:

• Completion/Passing all clerkship requirements

Fail – Repeat Family Medicine Clerkship:

A grade of Fail will be reported for students who score less than Pass on either of the Preceptor Evaluation or Didactic Project Evaluation, or score less than Pass on the written exam twice. The first time a student fails the written exam, the student will retake the written exam and receive an ID3 (Using Science to Guide Diagnosis, Management, Therapeutics and Prevention). The maximum final grade after one failure of the written exam is a Pass.

Table 1: Minimum Percentage for Grade Categories on the Preceptor and Didactic Project Evaluations

Grade

Minimum Preceptor
Percentage

Minimum Didactic
Project Average Score

Honors

88.9

83.3

High Pass

77.8

72.2

Pass

44.4

44.4

Table 2: Minimum Score Criteria for Grade Categories on the Written Exam

Grade

June-Sept %

Oct-Jan %

Feb-May %

Honors

78

81

84

High Pass

72

75

78

Pass

62

65

65

The Department of Family Medicine reserves the right to assign a failing grade for the entire clerkship if a student has performed in an unsatisfactory, unprofessional or unethical manner in terms of behavior with the preceptor, one of his/her patients or the site director.
back to top

Site Director and Student Coordinator Information
IU Department of Family Medicine Clerkship Contact Information
Long Hospital, Second Floor
1110 W. Michigan Street
Indianapolis, IN 46202-5102
Telephone: (317) 278-0300
Fax: (317) 274-4444
      Clerkship Director: Scott Renshaw, MD -- serensha@iupui.edu
      Programs Coordinator: Jennifer Burba -- jburba@iupui.edu
      Clerkship Secretary: Tonya Shelton -- toshelto@iupui.edu
      Associate Director Medical Education: Tom Jones, MD
      Director Medical Education: Richard Kiovsky, MD

Indiana Clerkship Site Contact Information

Evansville, Indiana -- Deaconess Family Practice
515 Read Street
Evansville, IN 47710
Telephone: (812) 450-6068
Fax: (812) 450-5052
      Site Director: Kim Volz, MD -- kim_volz@deaconess.com
      Residency Director: Kim Volz, MD
      Student Coordinator: Theresa Chadwick -- theresa_chadwick@deaconess.com 

Fort Wayne, Indiana -- Fort Wayne Medical Education
2448 Lake Avenue
Fort Wayne, IN 46805
Telephone: (260) 399-4231
Fax: (260) 423-6621
      Site Director: Paul Blusys, MD -- pblusys@aol.com
      Residency Director: Brenda S. O’Hara, MD
      Student Coordinator: Carolyn Hein -- hein@fwmep.edu 

Indianapolis, Indiana -- Community Family Practice
10122 E. 10th Street, Ste 100
Indianapolis, IN 46229
Telephone: (317) 355-1435
Fax: (317) 898-9760
      Site Director: Diana Burtea, MD -- eburtea@ecommunity.com
      Residency Director: H. Clifton Knight, MD
      Student Coordinator: Susan Thomas -- sthomas@ecommunity.com
      Behaviorist: Kathy Zoppi, PhD

Indianapolis, Indiana -- IU Methodist Family Medicine Residency
1520 N. Senate Avenue
Indianapolis, IN 46202
Telephone: (317) 278-0330
Fax: (317) 962-6722
      Site Director: Philip Ferguson, MD -- pferguson@clarian.org
      Residency Director: Sharron Grannis, MD
      Student Coordinator: Tonya Shelton -- toshelto@iupui.edu
      Behaviorists: Shobha Pais, PhD and Mary Dankoski, PhD

Indianapolis, Indiana -- St. Francis Family Practice
1500 Albany St., #807
Beech Grove, IN 46107
Telephone: (317) 783-8641
Fax: (317) 782-6872
      Site Director: J. Brooks Bolton, MD -- brooks.bolton@ssfhs.org
      Residency Co-Directors: Richard Feldman, MD and Worthe Holt, MD
      Student Coordinator: Jenny Kirby -- jenny.kirby@ssfhs.org
      Behaviorist: Allen Ferreira, PhD

Indianapolis, Indiana -- St. Vincent Family Practice
8220 Naab Road, #200
Indianapolis, IN 46260
Telephone: (317) 338-7600
Fax: (317) 338-7606
      Site Director: Maria Fletcher, MD -- mvfletc1@stvincent.org
      Residency Director: David Harsha, MD
      Student Coordinator: Diane Eastman -- dmeastma@stvincent.org
      Behaviorist: Thomas Barbera, PhD

Muncie, Indiana -- Ball Memorial Family Practice
221 North Celia Avenue
Muncie, IN 47303
Telephone: (765) 747-4454
Fax: (765) 741-1983
      Site Director: Amy Banter, MD -- abanter@chsmail.org
      Residency Director: Stewart Brown, M.D.
      Student Coordinator: Deb Stephens -- dstephens@chsmail.org
      Behaviorist: Linda Daniel, PhD
      Housing: Vana DuBois -- (765) 741-1095

South Bend, Indiana -- Memorial Family Practice
714 N. Michigan Street
South Bend, IN 46601
Telephone: (574) 647-7913
Toll Free: 1-800-850-7913
Fax: (574) 647-6819
      Site Director: Alberta Henderson, MD -- ahenderson@memorialsb.org
      Residency Director: Robert J. Riley, MD
      Student Coordinator: Justine Soboleski -- jsoboleski@memorialsb.org
      Behaviorist: Joyce Dunfer, PhD
      Housing: Patty Ganser -- (574) 647-7420 pganser@memorialsb.org 

South Bend, Indiana -- Saint Joseph’s Medical Center
837 E. Cedar, Suite 125
South Bend, IN 46617
Telephone: (574) 237-7637
Fax: (574) 472-6088
      Site Director: Jennifer Ludwig, MD -- ludwigj@sjrmc.com
      Residency Director: Martin Wieschhaus, MD
      Student Coordinator: Sherry Smith -- smithsh@sjrmc.com
      Behaviorist: Dominic Vachon, PhD
      Housing: Jeannie Wade -- (574) 237-7256; wadeje@sjrmc.com 

Terre Haute, Indiana -- Union Hospital Family Practice
1513 N. 6 1/2 Street
Terre Haute, IN 47807
Telephone: (812) 478-4183
Toll Free: 800-264-4717
Fax: (812) 238-7003
      Site Director: Melody Drake, MD -- mdrake@uhhg.org
      Residency Director: James Buechler, MD
      Student Coordinator: Vicki Miller -- fpvsm@uhhg.org
      Behaviorist: Joe Biggs, PhD
back to top

Course Description
The Clerkship in Family Medicine is:

• A required four-week clinical rotation for third-year medical students;
• Designed and administered by the Department of Family Medicine at the Indiana University School of Medicine;
• The first extensive exposure to ambulatory community-based medicine for many students;
• An opportunity for students to begin to develop the knowledge, skills and attitudes required to approach a problem in the primary care setting;
• Often much different from the traditional in-patient model that currently characterizes the majority of medical education.

The clerkship will introduce students to the principles and practice of Family Medicine. Students will:

• Observe how family physicians provide for the ongoing medical needs of their patients within the context of the family and community setting;
• Learn how to focus on discrete portions of a patient’s medical history and physical concerns within the confines of the patient’s total health;
• Meet patients who present with acute medical problems, chronic illness, in need of preventive health education, and seeking the support of their physician to cope with the trials and stresses of everyday life;
• See patients interacting with their “personal” physician and witness firsthand the therapeutic power of the doctor-patient relationship.
  back to top

Textbook
The textbook for the Family Medicine Clerkship is Essentials of Family Medicine, fifth edition by Sloane, Slatt, Ebell, Jacques and Smith. The end of clerkship is exam will be developed from a question bank based on this textbook with questions selected to emphasize the Core Diagnoses (page 16). Sample questions are available on the Family Medicine Clerkship Course Link at https://daly.medicine.iu.edu/med.

An excellent reference text, Family Medicine: Principles and Practice 6th edition by Taylor is available online through the Ruth Lilly Medical Library.
back to top