Sylvan Family Health Centre is proud to be a teaching practice of the Alberta Rural Family Medicine Network. The Network is an educational venture of the Rural Physician Action Plan (RPAP), the University of Alberta,the University of Calgary and the Province's rural physicians. Dr. Janke is further involved by being the site director at Red Deer Regional Hospital for the rural family medicine residency program. This means that there is often a third or fourth year medical student (a clinical clerk) and/or a family medicine resident working at the clinic. In either case they will be asked to see patients as part of their educational experience. A patient always has the option to refuse to see a student or resident.

The following is a description of what a resident or clinical clerk is:

1. What is a Resident?
After graduating from medical school, new doctors have to take further training before they can practice independently. These doctors work under the direct supervision of your family doctor or specialist and are known as Residents. Family Medicine Residents take extra training not only in Family Practices but also in hospital specialties. Residents have already spent many years working to become doctors. By the time they become Residents, they are able to write prescriptions, start intravenous lines, stitch up wounds and deal with medical emergencies.

2. Why are Residents working in Red Deer?
Many of you will know how hard it is to find a doctor in Red Deer or in the neighboring communities. Doctors that train in large cities like Edmonton or Calgary generally end up practicing there. The University of Alberta and the Rural Physician Action Plan has set up a new program based in Red Deer specifically to train doctors to practice in rural areas and in smaller cities. We hope that many of the doctors graduating from this program will become your family doctors in the near future.

3. What is the role of the Resident?
The role of the Resident is to work with your doctor. When you go to the clinic, typically the resident will see you first and then make a plan for your care with your doctor. Your family doctor remains completely responsible for your care and always directly supervises the resident. If you need to be admitted to hospital, our residents work with both your doctor and your specialist until you are back home.

We hope that you will feel comfortable having a resident involved in your care. If, for any reason, you would prefer not to have a resident in attendance, please inform the nursing staff.

1. What is a Clinical Clerk?
A Clinical Clerk is a third or fourth year Medical Student.

For the first two years in Medical School, students go to classes; attend small groups to discuss cases; go to lectures and labs. Starting in their third year, students learn mostly by seeing patients in many settings, such as hospitals and doctors' offices. These are referred to as "Clinical Rotations", and the student is called a "Clinical Clerk".

2. What is the role of the student in my Family Doctor's office?
The student is there mostly to learn basis skills.

They started learning these skills in the first two years of Medical school. In your Family Doctor's office, they may ask you about the problem that you came into the office for and this is called a history. They can do a physical exam, and they will talk to your Family Doctor about what they think the problem is (the diagnosis) and how it can be treated.

3. What is the level of care that a Clinical Clerk can provide?
A clinical Clerk does not have their MD (Medical Degree). They have to be supervised closely by their "Preceptor" who is your Physician. They can talk to your Family Doctor about what the problem is and how they would manage your concern. It is up to your Family Doctor to decide what is done. So, Clinical Clerks have very basic responsibilities.

4. When should my Family Doctor be in the room?
Clinical Clerks learn best if they get to see you first and when they are observed. They need to learn how to ask the right questions and to do this well, and to decide what physical exam is right for your. Often, your Family Doctor will ask the student to see you first. The student and your Family Doctor will discuss the student's findings and, before you leave the office, you will be seen by your Family Physician.

A Nurse, or your Family Doctor, should be present for any breast exam, pap test, rectal or testicular exam.

This if for your comfort as well as to ensure the student is observed during these exams. It is very important for all Medical Students to learn these important skills. Your Family Doctor may observe the Clerk doing other parts of your visit as well.

5. Can I refuse to see a Clinical Clerk?
Yes, you can refuse to see the student.

Clerks think it is a privilege to work with your Family Doctor. They know that there will be times that you may have problems that you wish only to discuss with your Family Doctor. The students will strive to always respect your choice, and treat your problems with care and respect. This is a very important part of the student's learning. Their visit with you is confidential; the same as when you see your Doctor.

6. What if I do not want to see a Student Physician of the opposite gender?
All physicians need to learn to show respect and be sensitive to all patients, and so we try very hard not to limit the learning students receive. We do respect that you, as a person, may not want to see a Clerk of the opposite gender and would encourage you to let your Receptionist or Family Doctor know if this is the case. We are, however, trying to train all of our students to be caring and sensitive, and so seeing patients for all types of problems is needed. Your help with this is very much appreciated.

7. What does the student add to my Doctor's practice?
Having a Medical Student in the office can be great for your Family Physician. Teaching can be hard work, but fun too!

Students bring questions and resources to your Family Doctor's office. Physicians who teach often enjoy their practices more than doctors who do not teach. Your Doctor may be trying to get students to come and practice in your area when they are done their training. Your Doctor may also feel a strong sense of duty to return some teaching to the Medical School as a way of thanking the school for the training they received.

The student can help your Family Physician answer questions by doing medical searches, writing a project, doing a chart review - all of which can improve the care that you get from your Family Doctor. Students can help do immunizations, pap tests, counsel patients about smoking and alcohol, and increase the role that your Family Doctor has in the area of health and disease prevention.

The Department of Family Medicine at Dalhousie University thanks you so much for your help in teaching students. If you have any questions or concerns about the Clinical Clerk, please talk to your office's Receptionist or your Family Doctor. From time to time, you may be asked to complete a form which helps to tract how well the Clinical Clerk did while they were seeing you. Your help is very much appreciated.

Students say the time they spend with Family Doctors in their office is one of the best ways they learn during Medical School.

Thank you for helping to make this happen!