Family Medicine

Chair: Joshua Freeman, M.D.
Family practice is comprehensive, continuous medical care regardless of the age, sex, or affected organ system of the patient. It emphasizes the preventive aspects of health care and treatment of the patient in context of his or her family and community. Treatment of the whole person is a hallmark of family practice.

FAPR 905 Rural Family Medicine—Practice and Research (4). This elective is offered to students between the first and second years of medical school. It is designed to provide students with the opportunity to observe a rural family physician in the daily practice of medicine and to participate in the data collection involving delivery of medical care to patients seen in rural practices in Kansas. Students will spend two summer months on site with a rural family physician, observing the practice and performing data collection. At the beginning and end of the two month on site experience, students will spend eight days with faculty in the Department of Family Practice at KUMC. Prerequisite: Permission of the instructor. FLD

FAPR 910 Clerkship in Family Medicine (4). The instructional objectives of the elective clerkship in family practice are to build on the skills and knowledge accumulated in the basic science areas and the other clinical specialty areas and reinforce them and apply them to the delivery of health services to the family unit and relate them to the individual, the family and the community. The clerkship, through supervised patient contact within the hospital and in the Family Practice Center and supervised teaching conferences, will amalgamate and reinforce the skills and previously gained clinical knowledge into the philosophy of primary health care delivery in breadth rather than depth. Offered in Modules I-XII. Prerequisite: Completed third year. FLD

FAPR 915 Medicine and the Family (2). This elective course on medicine and the family teaches students about family dynamics as they relate to the practice of medicine. Specifically, the course focuses on the family life cycle, normal and dysfunctional families, marriage, "normal" sexual behavior, and sexual dysfunction. These concepts will be applied to an understanding of such common medical issues as: family planning, disability, health screening, risk factors, death and dying, and child safety. Students will also be encouraged to learn about their own families by completing genograms, "family circles," etc. Students will be graded via two examinations, one completed written project, and class attendance. Prerequisite: Permission of instructor. FLD

FAPR 920 Research in Family Practice (2-8). Students desiring basic research experience in the context of Family Medicine may seek the sponsorship of a Family Practice faculty member and with that individual develop a written plan for the elective. The elective may vary in length from two weeks to three months and carries with it one credit hour for each sixty hours of time spent on the elective. Elective not available during July. FLD

FAPR 925 Interdisciplinary Community Partnership (4). This course is designed as an interdisciplinary team approach to developing strategies for community health assessment and intervention. Students will work with a team that includes at least three other health professional students and at least one community "lay health adviser" to assess the health needs of a local neighborhood and develop and implement an appropriate intervention. The course will explore community needs and resources, assess and barriers to care, and culturally appropriate interventions. No courses currently exist which involve an equal partnership with medicine, allied health, social work and nursing. This course is designed to give students the opportunity to learn to work as a team member with a variety of health care professionals, and to understand the valuable contribution of each group. Research has shown that students who are involved in the community during medical school continue to be actively involved in their chosen communities. This course is developed in concert with KU's Schools of Nursing, Allied Health and Social Welfare. This first year, two interdisciplinary teams will be assembled, working with 2 neighborhoods in the vicinity of KUMC. If this pilot is successful, more communities and teams will be assembled in future years. This is a year-long course that will span both fall and spring semesters. LEC

FAPR 926 AIDS Care in the Community (4). This elective is a concentrated experience in AIDS medical care provided in a family practice setting. The focus is on diagnosis, treatment and psycho-social issues for men, women and children with HIV disease (including gynecologic, prenatal and delivery of infected women). Care throughout the spectrum of disease is emphasized. The course is an additional elective to be made available to clinical medical students in the fourth year of training. LEC

FAPR 927 Palliative Care in a Community Setting (4). This elective is an end-of-life medical care experience including identification and treatment of medical problems associated with cancer, CHF, COPD, AIDS, and other life-shortening diseases. The course focus is on symptom management and psycho-social issues associated with dying. This course is an additional elective to be made available to clinical medicine students in the fourth year of training. LEC

FAPR 930 Interviewing and Counseling Methods (2). This course teaches students the skills of interviewing and basic counseling, as well as psychological diagnostic screening techniques and crisis intervention skills. Such skills are necessary for developing effective physician-patient relationships. At the end of this course students will demonstrate such effective interviewing skills as open-questioning, reflecting, confrontation, and interpretation as well as effective non-verbal listening skills. Students will also have opportunities to practice these skills and be evaluated on their technique. In addition, a final examination will be given to assess acquired knowledge in this course. Students will meet for forty lecture hours and forty practice hours. The course will be offered in the spring semester to first and second year students. Prerequisite: Permission of instructor. FLD

FAPR 931 Advanced Interviewing and Counseling Methods (2). This course is an extension of the basic Interviewing and Counseling Methods course (FAPR 930). Students will continue to learn the skills of interviewing and counseling by assisting with the teaching of FAPR 930. Students enrolled in this course will lead small discussion groups, teach basic listening skills, observe students role-playing these skills, review students' counseling audio tapes, and prepare final examination questions. Enrollees will be required to attend all class lectures, as well as small discussion groups. Their leadership and teaching skills will be evaluated by the students in their small groups. At the end of this course students will have improved their interviewing and counseling skills. They will also have gained valuable administrative and teaching skills through the experiences offered in this course. This course will be offered in the Spring semester to second year medical students who have completed FAPR 930. Prerequisite: Successful completion of FAPR 930 and permission of instructor. FLD

FAPR 960 Alternative Medicine (4). OBJECTIVES: 1. To expose medical students to the basic theory and practice of a variety of non-allopathic healing methods that patients currently seek to assist them with health concerns, so that the student will have a working understanding of these various modalities: a. Cultural medicine: herbs, curandismo, voodoo; b. Structural/manipulative medicine: osteopathy, chiropractic, body work, massage, movement (yoga, T'ai chi); c. Energy therapies: therapeutic touch, reiki, craniosacral, homeopathy, Chinese medicine (acupuncture, herbs); d. Mind-body medicine: mediation, relaxation response, biofeedback, etc.; e. Psychoneuroimmunology; f. Combinations: Ayurveda, naturopathy. 2. To engage students in dialogue with practitioners of a variety of healing arts, and expose them to literature describing research in these fields in order for the student to understand how a variety of approaches might be used to benefit patients. 3. To provide a framework for evaluating various methods and practitioners. 4. To provide a basis for further study of the potential integration of a variety of healing modalities into the student's eventual practice of medicine. TEACHING METHODOLOGIES: This course will consist of four major components: 1. Group lectures and demonstrations on campus at KUMC (2 half-days weekly). 2. Clinical observations in various practitioner's practices (5 half-days weekly). 3. Independent study including reading, library research, further experiential investigation of an area of particular interest to the student, culminating in the presentation of a written paper to the entire group during the last week of the course (2 half-days weekly). 4. Individual experiences which provide personal balance for the students and expose them to a new personal mind-body practice which they can incorporate into lifelong individual health habits—meditation, yoga, T'ai chi, etc. (1 half-day weekly). Specific two hour group didactic or workshop sessions would include the following: Session 1: Overview of Integrative Medicine—categories of methods, history of the field. Session 2: Psychoneuroimmunology (PNI)—The science of mind-body medicine. Session 3: Meditation—theory and practice. Session 4: Biofeedback—overview and demonstration. Session 5: Introduction to Energy Medicine—polarity, craniosacral, reike, therapeutic touch. Session 6: Traditional Chinese Medicine. Session 7: Homeopathy. Session 8: Herbal Therapies. Session 9: New Views on Nutrition—vitamins, supplements, food as medicine. Session 10: Ayurvedic Medicine. Session 11: Osteopathy—theory and practice. Session 12: Chiropractic—theory and practice. Session 13: Body work; massage, Feldenkreis, Heller. Session 14: Functional Medicine. Session 15: Spirituality in health and illness. Session 16: Chronic disease as a model for PNI and Integrative Medicine; Where from here? The four week course would be scheduled as follows: MON AM—Week 1: Orientation; TUE AM—Lectures and workshops; WED AM—Clinical experiences; THURS AM—Weeks 1-3: Clinical experience; FRI AM—Clinical experience. Weeks 2-4: Independent study: Week 4: Projects: Mon PM—Clinical experience: TUE PM -Lectures and workshops: WED PM—Independent study: THURS PM—Same as AM: FRI PM—Individual balancing experiences. PATIENT CONTACT: Students will be assigned half-day observation blocks in a variety of practitioners' offices throughout the four weeks. Some will be KUMC practitioners, some from the community; list of clinical sites with faculty. Approximate time spent by each student in the 18 clinical half day sessions is: Holistic/Integrative physician practice—2; Acupuncture/Chinese Medicine practitioner—2; Massage therapist -1; Biofeedback therapist—1; Therapeutic Touch practitioner—1; Meditation class—1; Homeopathic practitioner—1; Herbalist—1; Nutrition consultant—1; Chiropractor—1; Osteopathic physician—1; Compounding pharmacist—1; Energy work practitioner—1; Multidisciplinary pain clinic—1; Repeat visits or others by individual appt—2. EVALUATION: Students will be required to attend all class sessions and all clinical assignments (65% of grade). Each student will be required to research, write and present a paper to the group on a healing method of their choice, including the history of the field, the scientific basis for its practice, the types of patient problems it is suited to help, and the way in which the student might incorporate it into his/her future practice, if at all (30% of grade). Students will be required to keep a log of their individual health balancing practice (time spent, type of practice, etc.) and evaluate its benefit to them personally (5% of grade). COURSE SYLLABUS is under development. Will be largely articles from pertinent journals, handouts developed by lecturers. Required Tests: none. Recommended texts will be made available. LEC