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Doctoring and Clinical Skills-PURCH (DCS-P)

Includes: Physical Diagnosis (PD) & Longitudinal Preceptor Program (LPP)

Curriculum Summary

DCS-PURCH provides a solid foundation in your first two years of medical school as you begin forming your professional identity as a doctor.

This mentored, skills-based curriculum develops the skills to interact with, examine, diagnose, treat, and educate patients about their diseases and their treatments.

It also emphasizes the impact of social determinants of health, social history, community influences, and resources, on disease processes.

It is taught by Brightwood Learning Community mentors and core DCS-PURCH faculty from Baystate Health with whom you will form long-term relationships throughout all four years of medical school.

Curriculum Details

Year 1: Experiencing Patients and Their Communities (DCS1-P)

Our curriculum focuses on patient-centered healthcare delivery, weaving these 5 threads throughout.

  1. The Story—Discussion with members of our community on their experiences of illness and disease
  2. The Community—Visits to a local homeless shelter and jail to understand the impact of community on disease
  3. Healthcare Quality—Identify and impact healthcare disparities through a quality improvement lens
  4. The Patient—Discussions with a variety of patient populations, such as rural clinic, inner-city clinic, inpatients, military veterans
  5. The Diagnostician—An innovative clinical reasoning curriculum will be woven throughout all the teachings in the DCS1-PURCH course.

Year 2: Engaging with Patients and Clinicians in the Hospital (DCS2-P)

This course focuses on building upon the interview and physical examination skills learned in your first year through a series of observed hospital-based patient interview experiences at Baystate Medical Center.

During this year you will participate in ten hospital sessions with patients who may have a variety of disease processes such as cardiac, pulmonary, gastrointestinal, and neurological conditions. You will take the interview, write up notes, observe peers, and make oral presentations.

Your Learning Community mentors, along with Baystate resident educators from multiple specialties, will observe each medical interview and provide feedback on your interviewing and physical examination skills. From these experiences you will:

  • Engage with patients during their time of hospitalization—Practice the key tenants of our program by listening to the patient’s story to learn about the course of their clinical illness and also explore the impact of social determinants of health on their health and recovery.
  • Engage with members of the healthcare team—Experience firsthand our culture of delivering excellent patient-centered care, embracing education of our learners, and caring for one another in a welcoming, safe working environment.
  • Build upon the quality improvement foundations learned in DCS1-P—Identify the key quality measures that impact hospitalized patients and ensure these measures are being met to deliver safe, effective, and efficient patient care.

DCS-PURCH Educational Methods

DCS-PURCH has the same three educational components as at the main campus:

Small Group Sessions

Year 1

You will meet regularly with faculty facilitators to learn and practice skills in the core competencies, including the medical interview, clinical reasoning, teamwork, and presentation skills.

You will have extensive experience with patients from the community in both ambulatory and inpatient settings:

  • Visiting and interviewing patients at a jail and a homeless shelter
  • Meeting regularly with community faculty
  • Participating in a poverty simulation exercise
  • Experiencing first-hand food availability challenges in an urban environment
  • Discussing motivational interviewing in the context of substance use disorder in a rural environment
  • Practice taking a military history with community veterans
  • Hearing diverse perspectives from providers and patients about transgender health care

Year 2

Core educational session cover the topics of:

  • Developing differential diagnoses
  • Oral and written presentation skills
  • Challenging interviews
  • Working with medical interpreters
  • Problem solving

Physical Diagnosis (PD)

Year 1 & Year 2

This robust physical diagnosis curriculum includes both didactic and hands-on experiences, and coincides with your gross anatomy course.

Working under the direct observation of your Learning Community mentors,  you will practice the skills of physical examination and get timely feedback to improve technique.

Sessions include:

  • Introduction to general appearance and vital signs
  • Physical examination of the heart and vascular
  • Physical examination of the chest and breasts
  • Physical examination of the abdomen
  • Neurological examination
  • Physical examination of the head, mouth, neck
  • Arthroskeletal examination
  • An integrated physical examination

Longitudinal Preceptorship Program (LPP)

Year 1 & Year 2

The LPP is designed to provide you with the opportunity to experience the practice of medicine firsthand and begin to develop your identity as a physician.

During your first weeks of medical school you will be assigned a Longitudinal Preceptor with whom you will work for a year and a half. You will be placed in a clinical setting where you participate in clinical sessions with your preceptor—at first observing and then assisting hands-on with patient care.

You will gain experience:

  • Interviewing and examining patients, and taking a medical history
  • Dealing with different types of patient visits, including identifying preventive care practices, and appreciating the benefits of continuity of care
  • Receiving feedback from physicians and patients
  • Networking within the clinical system, and acting as part of an interprofessional healthcare team

You take part in eight sessions with your Core Preceptor and four sessions with a Rotating Preceptor. Preceptors come from a variety of medical specialties, allowing you to experience a broad range of clinical settings, such as:

  • Medicine
    • Allergy/Immunology
    • Cardiology
    • Family Medicine
    • Gastroenterology
    • Geriatrics/Palliative Care
    • Hospital Medicine
    • Internal Medicine
    • Nephrology
    • Pulmonology
  • Emergency Medicine
  • Medicine-Pediatrics
  • Obstetrics/Gynecology
    • Gynecologic Oncology
  • Pathology
  • Pediatrics
  • Surgery
    • Otolaryngology
    • Vascular Surgery

If you are a member of certain pathways at the main campus, you may have the opportunity to complete your Rotating LPP experiences in settings that align with those pathways. For example, students in the Rural Health Scholars Pathway may request to do a number of Rotating LPP sessions with a rural provider.

Integration with Other Courses

DCS1-PURCH's curriculum reinforces and integrates classroom learning in your First Year courses with your clinic-based sessions:

  • Integration with the concepts of Genetics and Determinants of Health will emphasize the broad determinants of health including the roles of genetics, behavior, and social environment in health and disease.
  • Principles covered in the Epidemiology-Biostatistics course underpin population health concepts.