Pre-requisite: Open to Family Medicine residents at the PGY2 level or above
Duration for Elective: 4 weeks
Rotation Director: Patricia Doyle, MD
Educational Objective
To provide the GME learner with clinical experience in an isolated rural primary care medical practice with unique additional exposure to acute emergent care, as the nearest emergency departments are 60-90 minutes away, and tertiary care is 2.5 hours away. Jackman Community Health Center is a remote FQHC, part of the PCHC family. It is a single provider practice in a community of about 1,000 people. The next closest practices are 60 minutes away. This rotation will provide insight into working with limited local resources.
The rotation schedule will be primary care / urgent care clinic at the Jackman Community Health Center Monday, Tuesday, Wednesday and Thursday 0730-1730 and on call with the Critical Access Integrated Paramedic (CAIP) Tuesday Night 1730-0730 and Thursday night 1730 through Monday 0730 with 10-15 hours of clinical service delivery during that period.
Experiences and Procedures
- Work in the family medicine clinic seeing a wide variety of patients with both chronic and acute illnesses. We are a small enough community that there is generally time for discussion of cases and situations throughout the day.
- Opportunity as it arises for procedures, including laceration repair, lesion removal/biopsies, cryotherapy, fish hook removal.
- Opportunity as it arises to participate in house calls with either the provider or the community paramedics. (There is no home health agency in this isolated community.)
- The acute care component also provides the experience of working with the group of specially trained paramedics who are part of a unique pilot program providing assistance to the clinic during office hours as well as after-hours care in conjunction with telehealth services from a remote urgent care provider. (These experiences can run anywhere from an earache to a laceration repair to providing TNKase for a STEMI patient while awaiting LifeFlight.)
- Residents will participate in facilitated tele-urgent care visits with the Critical Access Integrated Paramedic at the originating site and receive orientation to and training in the use of telehealth platforms and peripherals as an originating site and remote site user.
- Office hours are Monday through Thursday, 7:30am to 5:30pm, and experiences with the paramedics after hours can occur at any time.
Housing
Jackman Community Health Center offers on-site housing as part of its EMS services. Learners have a private bedroom with a TV and a private bathroom. The kitchen and living area is a shared space with the paramedics. The housing and EMS integration is critical to this health center’s unique operation.
