Genes to Society: A Curriculum for the Johns Hopkins University School of Medicine

Chronic Disease and Disability Clerkship: Improving Quality of Life

There are approximately 120 million Americans with chronic disease, of whom about 50 million have severe disability limiting their daily function. These groups account for 75 percent of medical care expenditures in the United States. This clerkship aims to better prepare future physicians across all specialties to manage these patients, who likely will comprise a large proportion of their clinical practice irrespective of the student’s ultimate career specialty choice. The students participate in direct patient care in inpatient and outpatient rehabilitation settings, visit a community center for people with disability and do a home visit. Students participate in team meetings and family conferences. Students perform simulation exercises which will give them a better sense of challenges faced by individuals with chronic disease and disability. There are weekly didactics and journal clubs.

Course Goals

By the end of the two-week course, students will be able to demonstrate the following knowledge, skills and behaviors:

Knowledge

State the prevalence and understand the impact of chronic disease and disabilities
Define principles of interdisciplinary team management
Discuss the evaluation and management of patients with chronic pain
Delineate nutritional issues in patients with chronic diseases and disabilities
Identify poly-pharmacy issues in chronically ill patients
Describe management of urinary bladder, bowel and sexual dysfunction in patients with disabilities
Identify limitations and resources in health care finances for the chronically ill and disabled patient

Skills

Demonstrate effective, empathic and culturally sensitive communication
Demonstrate approaches to effect behavioral changes in health promotion for persons with chronic illness
Perform a detailed functional evaluation, including delineation of impairments, activity limitations and participation restrictions
Prescribe routine rehabilitation services and durable medical equipment
Write progress notes, sign-offs and discharge summaries that optimize continuity of care

Behaviors

Describe the impact of chronic illness and disability on individuals, families and society
Participate in interdisciplinary goal-setting with patients and families
Demonstrate empathic attitudes towards persons with disability and chronic illness