PGY-1 – Community Medicine

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PGY-1 North Country Community Medicine 

Rotation Contacts:  
Ed Paul MD, North Country HealthCareepaul@nchcaz.org #: 928-522-9566 
Matthew Maurer MPH, Coconino County Health and Human Services (CCHHS)mmaurer@coconino.az.gov #: 928-679-7332 

Description of Rotation and Educational Experience: 

  • This curricular component is a four-week block experience designed to integrate clinical medicine in a residents’/learners’ continuity clinic with enriching experiences in community health at the Coconino County health department and other community stakeholder organizations, culminating with a tangible project to be presented by the end of the rotation. 
  • A significant part of the curricular component learning epidemiologic concepts, public disease education, and other public health efforts while embedded at the CCHHS and other community stakeholder organizations. 
  • In addition, learners will have immersive experiences in North Country’s public health/outreach department which may include home visits for Healthy Steps (pediatric developmental and pre/postnatal support) and Ryan White program (HIV care management) as learner see’s fit to their project. 
  • Finally, learners will complete a cumulative project by the end of the block in the form of a QI project, qualitative project, or community needs assessment under the guidance/mentorship of the faculty sponsor.   

Teaching Methods: 

  • Learners will be oriented to the goals/objectives, schedule  
  • During the Community Medicine rotation learners will attend regular Family Medicine didactic sessions and will present a topic assigned to them by end of the rotation. 

Curriculum Goals: 

  • To provide NCHC Family Medicine residents and other learners (4th year medical students) with tangible examples of the interaction between their clinical practice and the public health sphere. 
  • Residents should achieve understanding and competency in objectives below. 

Community Medicine Objectives 

Practice-Based Learning and Improvement:

  • Learns and improves via performance evaluation 
  • Learns and improves at the point of care 
  • Learns and improves via feedback 
  • Monitors practice with a goal for improvement 

Patient Care and Procedural Skills:

  • Care of the outpatient and their relation to community health 
  • Systems-Based Practice 
  • Transitions patients effectively within and across health delivery system 
  • Recognizes system error or inefficiency and advocates for system improvement 

Medical Knowledge 

  • Demonstrate growth toward mastery in clinical knowledge of above domains 

Interpersonal and Communication Skills 

  • Works and communicates effectively within an interprofessional team 
  • Communicates effectively with patients and caregivers 

Professionalism 

  • Accepts responsibility and follows through on tasks 
  • Appropriate utilization and completion of health records 
  • Exhibits integrity and ethical behavior in professional conduct 

Specific Learning Objectives for this rotation include: 

Fundamentals of Epidemiology: 

  • Understand concepts like incidence/prevalence 
  • Evaluate sensitivity, specificity, PPV, NPV 
  • Conduct disease outbreak investigation 

Fundamentals of Community Based Outreach: 

  • Understand community outreach resources at NCHC 
  • Understand how to utilize and leverage resources to effect patient care 
  • Conduct home visit for various outreach programs 

Fundamentals of QI and qualitative research: 

  • Critically evaluate literature 
  • Differentiate between study types (cohort, case-control, randomized controlled, nonrandomized (community) trials 
  • Differentiate bias types  
  • Complete QI training 
  •  STFM curriculum 
  • Under faculty mentorship design, implement, and analyze a QI or qualitative project 

Community Needs Assessment 

  • Review county and previous learners’ Community Needs Assessments 
  • With county health department mentorship, evaluate and develop a Community Needs Assessment 
  • Visit community 
  • Analyze health disparities 
  • Identify opportunities for improvement 
  • Present Community Needs Assessment at final FM didactic session of block 

Evaluation and Feedback: 

  • Learners will be given regular formative feedback by faculty during their rotation and are encouraged to have an explicit mid-day rotation progress feedback session to help guide performance 
  • Faculty will complete formal evaluation through new innovations at the end of the rotation 
  • Learners will evaluate faculty and the rotation through the new innovations platform 

Reading List: 

Sample Schedule: 

 Week 1Monday Tuesday Wednesday Thursday Friday 
AM Orientation/FM Clinic FM Clinic CCHD CCHD NCHC Outreach 
PM FM Clinic NCHC Outreach CCHD FM Didactics CCHD 
  Week 2Monday Tuesday Wednesday Thursday Friday 
AM FM Clinic FM Clinic CCHD CCHD NCHC Outreach 
PM FM Clinic NCHC Outreach Project Time FM Didactics CCHD 
  Week 3Monday Tuesday Wednesday Thursday Friday Saturday 
AM FM Clinic FM Clinic CCHD CCHD FM Clinic FM Clinic 
PM FM Clinic Project Time NCHC Outreach FM Didactics Project Time Off 
  Week 4Monday Tuesday Wednesday Thursday Friday 
AM FM Clinic FM Clinic CCHD CCHD FM clinic 
PM FM Clinic Project Time NCHC Outreach FM Didactics 
(Presentation) 
Off 

Including 

  • 4 half days/wk of FM clinic each week (16 hrs) 
  • 2 half days/wk of community outreach with NCHC programs 
  • 3 half days/wk of CCHD experience 
  • NCHC Outreach would be tailored to the learners’ interest/project to include but not limited to: NACASA, HIV/RW Program, Shelter Services, Healthy Steps (community outreach), Healthy Start (child development), Hepatitis C Community Screening, etc. 
  • CCHD experiences would be tailored to the learners’ interest/project to include but not limited to: epidemiology, disease education, informatics, family planning and STI treatment clinic, etc. 


Author: Brandon Abbott
Associate Program Director. My passions are teaching and watching the light bulb go off. I benefited from fantastic mentorship and inspiring clinical instruction and hope to pay it forward!