Combined Inpatient & Outpatient US Clinical Experience in Internal Medicine in Houston

Information about this clinical experience:

This rotation split between the inpatient and outpatient settings will be under the supervision of a board-certified internal medicine physician. This physician has been a well-regarded teacher dating back to residency. Growing up in a small town in Texas, this physician returned to the area and joined a small group practice in an underserved area. The residents of the community largely work in manufacturing and fishing.

The benefits of rotating with this physician are the opportunity to learn and practice rural medicine. Although nearly 20% of the U.S. population resides in rural communities, there are disproportionately fewer physicians in these areas. Multiple studies have shown higher mortality rates in patients living in rural regions.

Within the specialties of internal medicine and family medicine, there has been a strong push to open up residency training positions in rural. This push started in the 2010s with family medicine and now, in the 2020s, internal medicine has followed suit. Congress has approved funding for rural training. In 2019 and 2020, nearly $ 30 million was awarded to organizations across 25 states, earmarked specifically for starting rural residency programs in family medicine, general internal medicine, and psychiatry.

For the IMG, this will be an excellent opportunity to experience medicine in an underserved rural area and to see if the setting is a good fit for you. Your involvement in this rotation has the potential to make you a more attractive candidate to residency programs that have a rural focus or component.

In the clinic, you will see patients with both acute complaints and chronic disease. You will learn how to evaluate these patients through focused history-taking and examination and synthesize the data to form an assessment and plan. During discussions with the attending, important teaching points related to these cases will be shared with you. Of note, the patient population that the preceptor cares for includes many patients with multiple comorbidities. Therefore, this experience will be an excellent opportunity for you to learn how to manage patients with complex medical and social conditions. This physician is well regarded for providing patients with personalized care and believes in taking the time necessary to listen to patients and make them feel heard.

Hospital rounds will take a place at a nearby hospital. The frequency and duration of these rounds will depend upon the patient census in the hospital. Rotators can expect to visit the hospital once or twice per week.

After a few days of observation, you will take on an increasing role in patient encounters and learn the following under the preceptor’s supervision:

• Taking patient histories under supervision.

• Performing exams under the physician's supervision.

• Presenting patients.

• Writing or entering notes in the EMR

• Researching the literature to answer clinical questions at the point of care.

• Educating patients under supervision.

• Spending time with other healthcare professionals to understand their roles and responsibilities.