Students are assigned to a variety of practices within the urban or rural area for a supervised exposure to day-to-day practice problems. Emphasis is on the application of clinical skills within the demands and limits of actual practice. Program is sponsored by the Texas Academy of Family Practitioners. Applications must be completed several months in advance.

This elective allows students to gain additional skills and experience with end-of-life care in a variety of hospice and palliative care settings. Students have the opportunity to work with multidisciplinary care teams that provide holistic medical management of persons near death, with a special emphasis on symptoms and decision management at the end of life.

This elective is set in an ambulatory clinic and emphasizes the breadth of family medicine. The student will have an opportunity to care for a wide variety of simple and complicated problems, practice patient counseling and education skills, and to be able to see some patients through a brief illness with follow-up care. Family-oriented health care, family dynamics, preventive care and the team approach to health care are emphasized.

Patients of all ages, of both sexes, and with diverse medical problems will be managed in this sub-internship. Emphasis will be given to the total management of the patient, beginning with the ambulatory presentation, continuing through hospitalization and following dismissal from the hospital-coordinated, comprehensive, continuing medical care. The student will be responsible for complete evaluation of the patient, including initial history and physical examination, cost effective utilization of laboratory, x-ray and other procedures and the formulation and pursuit of the management plan, including cogent utilization of consultation/referral services. Emphasis will also be given to participation in community resources, which provide ongoing care of the patient, including Hospice and community health centers. Experience is afforded in the Family Practice Center, the inpatient service of family medicine, certain area nursing homes, and on occasion, in the home of the patient. The student will function with Family Practice residents under the direction of the Family Medicine faculty member assigned to the inpatient service and other Family Medicine faculty members.

This rotation will replicate the role of an Intern on a very busy hospital medicine service where the reporting physician is not another resident, but an attending for one on one mentoring. A very broad exposure to the entire swath of inpatient within the Academic Teaching hospital will be experienced.

Students will be required to create and teach educational classes for patients and staff at Heal the City. They may also assist with patient data analysis and clinical encounters. They will also become familiar with the operations, challenges and benefits of non-profit healthcare programs, grant acquisition and free patient care. The course will have required tasks but is also flexible to achieve the goals set forth by the student, Heal the City staff and course director.

This course will provide a community medicine experience in the rural Big Bend and Permian Basin area with the TTUHSC-Permian Basin Rural and Community Engagement (RCE) Division. RCE was created to build bridges between our community partners that TTUHSC-PB serves. Regular RCE activities include community outreach activities which include resident physicians as well as multidisciplinary students from the Schools of Medicine, Nursing and Health Professions. Additionally, RCE does influenza vaccination clinics at community sites. A major emphasis of RCE is also working on the HRSA Hispanic Center of Excellence (HCOE) grant which aims to train more Hispanic physicians for west Texas. The RCE group has weekly grant meetings to coordinate health fairs, mentoring programs and shadowing opportunities for premed-interested high school students and premed university students. The students doing this elective will be participants in all RCE activities for the month. A particular emphasis of the course will be focused on advocacy for our vulnerable populations in our communities. Discussion and involvement on interview with journalists, policy makers and legislators will occur during this month. Discussion of health care policy and access to care for our communities will be a focus during the month. Additionally, students will be required to do the Canopy Medical Spanish Course during the month. As part of the HCOE grant, a working group of TTU Spanish Faculty and TTUHSC Faculty are working on development of a Medical Spanish and Hispanic Culture grant. The students will be involved in these meetings as well. Rotating students will be encouraged to publish a manuscript related to health care disparities.