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.
By the end of the two-week course, students will be able to demonstrate the following knowledge, skills and behaviors:
- 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
- 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
- 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
R. Sam Mayer, M.D.
Time Commitment and Course Length
This course meets for two weeks.
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