PMCU-4001 - Public Health in the Community

PMCU-4001 - Public Health in the Community

Elective Title: Public Health in the Community
Course Number: PMCU-4001
Elective Type: career Duration/Weeks: 4 Max Enrollment: 10
Prerequisites: Successful completion of Year 2
Additional Requirements: C form is required to enroll, please contact Dr. Agana prior to enrollment to discuss course schedule. You must register no later than 4 wks prior to the start of the elective.
Responsible Faculty Director: Denny Fe Agana, PhD, MPH, CPH & Leslie Stalnaker, MPH Periods Offered: 1-7, 9-13 excluding holiday period 8 
Coordinator: Tawny Stromberg & Amber Anthony Other Faculty: Cara Pennel, PhD
Location to Report on First Day:
Maurice Ewing Hall, 700 Harborside Drive, Room 1.116

The student will become familiar with the roles and responsibilities of a Public Health Physician and investigate the relationship between the community based primary care physician and the local public health network.

By the end of the elective the student will be exposed to the three core functions and ten essential services of public health, the relationships between clinical practice and public health, the impact of policies on health care and health outcomes, and health issues of vulnerable populations. During the rotation, students will become familiar with methods of assessing community needs and strengths and options for intervention, evaluating strength of public health evidence, communicating information with diverse audiences, and identifying and addressing social determinants of health.

Description of course activities
The four-week course will include one week (40 hours) of rotations through Galveston County Health District or a comparable public health agency where they will rotate through different departments to familiarize themselves with the various roles of a local health department. The student will spend the remaining time rotating through different community-based clinical settings in the Houston/Galveston area. Possible settings include (but are not limited to): mobile clinics, homeless shelter, school-based clinics, and clinics in underserved communities. Along with the rotations, students are assigned readings on public health topics that are relevant to understanding gaps and linkages between public health and medicine and how to integrate the two fields as a clinician. For the final assignment, students are required to write a reflection paper in which they will discuss their experiences at rotation sites, as well as how they can apply the assigned readings to their future practice.

This course satisfies the Community Engagement and Public Health Concentrations.

Type of students who would benefit from the course
Students interested in public health, community-based medicine, and working with underserved populations.

Weekly Schedule
  Clinical Activities (estimated schedule)  
Day of Week   AM   PM

 Average number of patients seen per week: N/A
 Call Schedule: N/A

Research Activities (estimated schedule)
Activity Hours per Week
Faculty Contact-Time 1-2
Self-Directed Study 2-4
Data-Collection/Analysis 2-4
Other Rotations 24-32

Method of Student Evaluation
1.  Clinical Observation
  A. Where are students observed on this elective?
    Inpatient Service   Ambulatory   Surgery   Standardized patients
Patients simulators   Other
  B. Frequency - How often are students observed clinically?
  C. Format - What method(s) are used to document the student's clinical performance?
    Daily oral feedback   End of period oral feedback   Written feedback

2.  Oral Presentation
  A. Audience - To whom does the student present?
  B. Frequency / Duration of Presentation(s)?
  C. Format - What guidelines are set for the student's presentation?
  D. Assessment - Who assesses the student's presentation performance?
    Self-assessment   Peer assessment   Faculty assessment
  E. Method of content selection
    Current cases  Student-selected topic   Assigned topic

3.  Written Assignment (H&P's, notes, papers, abstracts, etc.)
  A. Frequency of written assignment(s)?
    End of course paper
  B. Format - What guidelines are set for the student's written work?
    A final paper describing and reflecting on their experiences during the rotation, application of the assigned readings, and implications for their future practice
  C. Length of written assignment(s)?
    Abstract   Annotated bibliography   1 - 2 page paper   3+ page paper
  D. Are recent references required?   No    If yes, how are they selected?
  E. Method of content selection - e.g. student-selected, relate to cases, etc.?
    Student-selected based on topics relevant to experiences during rotation and faculty-assigned readings
  F. Audience - Who assesses the student's written performance?
    Peer Assessment     Faculty Assessment     Other

4.  Examination
    Oral   Written multiple choice   Written essay / short answer   OSCE

5.  Extra Course Activities
  What expectations do you have for the student to demonstrate participation in the elective (e.g. small group activities, seminars, thoughtful questions, providing resources, journal club, resident lecture attendance)?
    Timely arrival, active participation, completion of readings, and professionalism during all rotations with external partners.

6.  Additional Costs
  Please list any additional costs and/or purchases (books, materials, movies to watch, etc.) that are required for this course. Include an estimated total cost. If there are no additional costs, please enter "None".

7.  Other Modes of Evaluation
  Please explain below.

8.  If this course is an Acting Internship, please complete the following:
  A. Objectives for the AI should relate directly to the Entrustable Professional Activities (EPAs). Each AI should describe how the four key Year-4 EPAs that our school has identified as being Year-4 skills are assessed. The Year-4 objectives are:
1. Entering and discussing orders/prescriptions.
2. Give or receive patient handover to transition care responsibility.
3. Recognizing a patient requiring urgent or emergent care and initiating management.
4. Obtaining informed consent for tests and procedures.
Specify how the student will be given formative feedback on their clinical skills.

Year-4 students should demonstrate mastery of EPAs they developed in the clerkship year, including recommending and interpreting common diagnostic and screening tests, and performing general procedures of a physician. They should be able to demonstrate masterfully and independently skills they mastered in Years 2-3, including efficiently performing comprehensive admission-notes and succinct daily progress notes and perform accurate, concise, and hypothesis-driven clinical presentations, form clinical questions and retrieve evidence to advance patient care. They should be able to demonstrate basic understanding of and beginning mastery of collaborate as a member of the interprofessional team and identify system failures and contribute to a culture of safety improvement.

List advanced clinical skills that a student will be assured an opportunity to practice.

How specifically will this AI build on developing skills from the clerkship year to prepare students for internship?

What opportunities will typically be available to all students who take this AI (procedures, required presentations, etc.)? What opportunities may be available based on patient load/presentation or student initiative (ie. Writing a case report)?

An AI should have expectation of a minimum of 32 hours per week of clinical responsibilities. Duty hours should be capped at ACGME limits for an intern, thus up to 24 hours followed by 4 hours of activities related to patient safety, education, and handoff. Students cannot work more than 80 hours per week averaged over 4 weeks. They can only have 1 day off in a 7-day work week with 8 hours off between shifts.

Clinical responsibilities will vary depending on specialty, but how is the student functioning with work commensurate to a PGY1 with an appropriate level of training?

How is the student demonstrating drawing clinical conclusions and/or developing a management plan and documentation as an intern would do?

How and by whom will midpoint feedback be provided to the student? How will you remediate deficiencies identified at midpoint?

Acting Internship students often seek letters of recommendation following their experience. How many different Faculty will work directly with the student and have knowledge of the student's abilities to detail in a written evaluation? Describe the degree of supervision and interaction with faculty vs. residents or other providers and how feedback will be obtained if more direct work is with residents or other providers.