How to do well on Family Medicine
In addition to emergency medicine physicians, family medicine physicians are one of the last bastions of "true" medicine in that they can manage, to some extent, mostly anything that walks into their clinic. From broken arms to delivering babies to depression to diabetes, family medicine physicians manage the whole gamut. As a third year medical student rotating on outpatient family medicine, you will be expected to conduct a thorough history and physical on each patient and then succinctly present each patient to your attending with your assessment of their ongoing issues and your plan. For the sake of chronology, we will assume that family medicine is one of your first rotations.
The basic, complete history
Chief Complaint
"The 7 Dimensions" (Best used to characterize pain)
Chronology
Location
Radiation
Severity
Quality
Associated Symptoms
Aggravating/Alleviating factors
Review of systems
Medications
Allergies
Past Medical History
Past Surgical History
Family History
Social History
Tips to do well on your Family Medicine rotation
Learn the basics of a thorough history
This will carry you far through the remainder of third year and beyond. Read the Internal Medicine Guide for a thorough look at presenting your history and physicals.
Learn to do directed physical exams
As there is a limited amount of time in clinic, learn to identify which organ/body systems should be examined for certain diseases and chief complaints. A good rule of thumb, however, is that heart and lungs should be examined for each patient, regardless of their chief complaint. Take some time to get proficient at taking blood pressures and auscultating,
Learn to present
There is an universal, stepwise approach to presenting patients which you can read here. Getting this down pat will make you look like an all-star.
Understand the flow of clinic
Get to know the nursing staff and learn the sequence in which patients first come to the clinic, are checked in, are evaluated by the nurse, and are roomed. Knowing this sequence and knowing when you can enter a roomed patient will help things move much more efficiently and smoothly.
Participate in procedures
If there are opportunities to do pap smears, inject a TB skin test, or freeze moles off, ask to do it! Not only are they fun to do but they are unique skills that you may utilize as you progress in your training. Also, it is always nice when, in the future, and in a clinic with a, perhaps, not-so-lenient attending, you are allowed to do a procedure because you have done it before under the auspices of the friendly family medicine attending.
Make small talk
Take some time to chat with your patients and get a sense of who they are as human beings. Learn to relate to others. You'll find that your communication skills, your ability to make small talk and connect with others, and your ability to seamlessly go from topic to topic will become exponentially better during this rotation, all of which helps prepare you for your Step 2 CS exam in a year.
Continue running through questions
The shelf exam for Family Medicine is one of the harder shelf exams during third year because it pulls general, internal medicine questions in addition to questions from Pediatrics and Obstetrics & Gynecology. If your family medicine rotation is one of your first rotations, it can be hard to review everything quickly. It is best, in this case, to run through questions to identify the concepts that are tested, in addition to reading through a review text. Keep a special eye for screening questions (for example, when you start ordering colonoscopies, pap smears, the dexa scan...etc), as these questions are preferentially questioned in the family medicine shelf.