OHSU FAMILY MEDICINE
Medical Student Education
The Family Medicine Department has played a key role in predoctoral education at OHSU since 1992, when Bill Toffler, MD, and Scott Fields, MD, provided leadership for the development and implementation of a new longitudinal course for first- and second-year medical students called “Principles of Clinical Medicine” (PCM). At that time, grant funding enabled OHSU to revise its basic sciences curriculum and add coursework focused on teaching knowledge, skills, and attitudes core to the practice of medicine. Co-directed for many years by Drs. Toffler and Fields, PCM retains its original structure to this day, offering students early and sustained exposure to clinical medicine. Each week students spend four hours with practicing physicians and (providing them with four hours) of coursework offering training in medical ethics, behavioral sciences, epidemiology, health care policy and economics, and a variety of other areas involved in patient-centered care. Dr. Fields continues to direct the PCM Preceptorship and is the facilitator of the PCM Leadership Team.
Family Medicine came into its own as a discipline at OHSU just a year after PCM was implemented. In 1993, the formerly multidisciplinary clerkship devoted to teaching ambulatory care officially became the required Family Medicine Clerkship, currently directed by Dr. Toffler and Kathy Chappelle, MA. Not long after, in 1997, in cooperation with AHEC centers around the state, another clerkship devoted to rural primary care was developed. Under the present leadership of Lisa Dodson, MD, the required Rural Community Health Care Clerkship (formerly known as the “Primary Care Clerkship”) provides students with housing with the assistance of state AHEC funding, and ensures that future physicians trained at OHSU all have been trained at some point in a rural or underserved environment.
In 1999, the Family Medicine Subinternship was developed, providing students with a fourth-year four-week elective in Family Medicine. Directed by Shawn Blanchard, MD, the subinternship includes both outpatient and hospital training and is both more rigorous and more standardized than former fourth-year electives. Previously offered only at OHSU, subinternship sites now include Providence Milwaukie Family Medicine Residency, Southwest Washington Family Medicine Residency, and Klamath Falls Family Medicine Residency.
In addition to required course offerings, Family Medicine faculty have developed popular predoctoral electives in areas of student interest. Anita Taylor, MA.Ed, is offering an elective on medical specialties, John Saultz, MD, is offering an elective focused on health care policy, and Valerie King, MD, Johanna Warren, MD, and Jessie Flynn, MD are co-teaching an elective on labor and delivery. By far the most visible and popular elective offered over the years by the department is the Summer Observership, first developed by Ms. Taylor in the summer of 1987 and still going strong. The Summer Observership offers incoming medical students the opportunity to live and work for a week with volunteer family physicians in communities all over Oregon. Ten years ago, we added the “Rural Family Medicine Experience” elective, giving students in between their first and second years of medical school the opportunity to work for one or more weeks with a family physician. Both the Summer Observership and the RFME are currently directed by Peggy O’Neill.
It would not be possible for our department to provide virtually every student graduating from OHSU with a solid grounding in our discipline without our cadre of dedicated volunteer faculty instructors who precept students for PCM and particularly for the Family Medicine and RCHC clerkships. The majority of students in our core clerkship are taught by volunteer family physicians, and approximately 90% of the volunteer faculty teaching in the RCHC are family physicians. Our sense of pride at what we have accomplished here at OHSU must be shared by the many devoted family physicians who have contributed to family medicine education.