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INTD 7005 Indian Health Service Rotation

health care The goal of this elective is to provide the senior level student with an exposure to rural family practice-model medicine in a cross-cultural setting. As this type of practice setting involves broad community and hospital involvement, the elective does also.

Application
Students interested in MEDI 7002 should contact Dr. Ruth Berggren at humanities@uthscsa.edu Once approved, the medical student coordinator at the Crownpoint IHS facility can reserve a time slot in advance. As this elective is popular and often fills months to a year in advance, it is advisable to meet with Dr. Berggren and contact the IHS coordinator as early as possible to verify that space exists. Once that is done, the student should submit a letter of intent and a current curriculum vita. The letter should include the specific dates in which you are interested, as well as a return address and phone number. The student will then be tentatively entered into the schedule and an orientation packet will be mailed in response.

Prerequisites
Because of the level of responsibility given the student, it is requested that the student completes the majority of the required core clinical rotations prior to arrival. Preparing for Global Health Work (INTD 4030) is suggested.

Content of the Elective
The elective is generally four weeks but, on occasion, may be as long as eight. The majority of time is spent in the outpatient setting in the Urgent Care, Emergency Department and Outpatient Department Specialty and Continuity clinics. In addition, you may spend time on the Med/Peds/OB inpatient wards as well. The experience may also include visits to each of two separate satellite clinics (PuebloPintado and Thoreau); and home visits with public health nurses.

The medical student is to attend morning rounds each day beginning at 7:30 AM. At 8:30 AM patient care begins and continues until approximately 6:00 PM with a half hour to a hour lunch break at noon. The student will be scheduled four days a week , with three-day weekends. The student will be paired with one of the facility's twenty providers, including family practitioners, pediatricians, physician assistants and nurse practitioners.

Early on in the rotation the student may accompany the provider in seeing patients to provide an opportunity for observing their clinical style as well as to orient to the Navajo culture. Following that, the student will see patients independently and report back to the primary provider to present and discuss the visit prior to the patient's departure. Historically, students participating in this elective have demonstrated excellent clinical and decision-making skills, and have enjoyed the autonomy.

We don't have a place for you to sleep in the hospital, so after-hours call usually involves an evening shift in the emergency department, inpatient wards, or obstetrical suite. We do generally schedule each student to spend one weekend (1-2 ten hour shifts) working in the emergency department with the on-call physician, compensating them with a day off.

Other activities include participation in weekly continuing education lectures covering a wide range of topics pertinent to the practicing family physician. The student may be asked to give a brief presentation on a topic of mutual interest, either to the medical staff or a group of patients.

Evaluations
Evaluation of the student will be done using the form provided by the medical school in which he/she is enrolled. Written evaluations will occur at the completion of the rotation, though we do attempt to give midpoint feedback directly to the student.

Living Arrangements
Housing is provided at no expense for all students and residents visiting our facility. This includes students from other departments including Dental, Optometry and Pharmacy. The accommodations are spartan but have the usual amenities such as a kitchen, full baths, bedrooms and living area Essential cleaning and cooking ware are also included. Telephones are available for emergency use only. Students should bring calling cards for long-distance. Housing units are located 5 minutes from the hospital by car and a short walk from running, hiking, and mountain biking trails on the mesa. Bed linen and towels may be obtained from Housekeeping in the main hospital.

Additional information on life in Crownpoint will be provided in the orientation packet once a student has been selected for the elective.

Grading
Students will receive a letter grade for this rotation. Grades will be determined based on evaluation from on-site preceptors and a reflection essay.