Med Student Volunteer Duties

Thank you for volunteering at Clínica!

Medical students have an important job at clinic: to elicit patients' histories and obtain detailed physical examination findings, report them to the preceptors, and manage patients' care. There's a lot to keep track of, but with some preparation and guidance from our other volunteers, in no time you'll experience the satisfaction of working with our clinic team and patients.

Clinic operates on Saturdays, from 8AM to about 2PM, depending on patient load.

HOW TO PREPARE FOR CLINIC

  • A few days before your shift, set up a carpool with the other volunteers working that day so you don't get stuck taking MUNI or having to fight for parking.
  • Come in professional attire. Bring a stethoscope, penlight, UCSF name tag, and Maxwell’s (optional). No white coat needed.
  • Please review patient history taking and physical exam skills.
  • Review SOAP note format and familiarize yourself with the blank sheets on which SOAP notes will be written.
  • Practice your medical Spanish, but don’t worry there are interpreters available on site.

CLINIC SCHEDULE

  • 7:00AM: Arrive at clinic to help set up. Preferably, arrange rides with the other volunteers on your shift. See the Yahoo Calendar.
  • 8:30AM: Brief pre-clinic meeting with all staff, led by the monitor
  • 8:45AM: Begin seeing patients. The clinic monitor will hand you the chart of the patient you are to see first. Remember that the monitor is in charge of the flow of the clinic day. The chart will include the chief complaint and vital signs of the patient, taken by the intake team. If you have questions about the chief complaint and what to focus on in your history and physical, please let the preceptor know.
  • 8:45AM - 2:00PM - Clinic Hours. See patients, present them to the preceptor, and write SOAP notes for each patient.
  • 2:00PM - 2:15PM - Post-clinic. Typically, an interesting or illustrative case of the day will be presented either by the medical student or preceptor. Also any issues that may have arisen during clinic will be discussed.

CLINIC FLOW & RESPONSIBILITIES FOR DAILY CLINIC PROCEDURES

Patient Registration: SFSU receptionist
Triage: SFSU clinic monitor, medical student coordinator, & MD preceptor
Patient Intake (Vital Signs and Chief Complaint): SFSU intake volunteers
Focused Health Education in waiting area: SFSU patient education volunteers
History & Physical: UCSF medical student volunteers (likely MSI/II)
Assessment & Plan: UCSF medical student volunteers & MD preceptor
Patient Discharge: SFSU pharmacy team instructs patient about how to obtain and take any medications prescribed; SFSU referrals team instructs patients about how to obtain any needed referral services; SFSU lab team instructs patient about how s/he will be informed of lab results; UCSF medical student volunteers instruct patient about any necessary follow-up visits to clinica

THE MEDICAL STUDENT - PATIENT INTERACTION

Chart / Patient Flow / Monitoring

  • Receive your patient chart from the Clinic Monitor
  • Read through the vital signs, chief complaint, and any past medical history elicited by the Patient Intaker
  • Ask the preceptor about what to focus on with that particular chief complaint
  • Elicit history from patient
  • Perform a focused physical
  • Present the patient to the preceptor, and together come up with a treatment plan that will likely involve one or more of the following: Medicines (pharmacy), lab studies, and/or referrals.
  • Remember to check in with the monitor as your patient goes through the different stages of the clinic (i.e. Intake, Interview, Pharmacy, Labs, Pharmacy, Done) to make sure a patient is not sitting alone for long periods.

Pharmacy FIRST

  • If the MD preceptor indicates that your patient requires medications, FIRST (before drawing any labs or filling out any referral forms) request that the SFSU pharmacy team begin the process of determining the lowest cost and most logistically feasible method of obtaining the necessary medications.
  • Begin this process by filling out the Pharmacy Log with patient’s name, date of birth, rx wanted, indicate urgency in obtaining meds for patient (can they wait to be signed up for DAP), frequency of meds (long or short term). The SFSU pharmacy assistant will research how to obtain the medications at the lowest cost and direct you from there.
  • This research generally takes a long time. Sometimes DAP (low income patient) paperwork requires a patient signature. DAP paperwork also takes a long time to prepare.
  • If the Pharmacy Team has not already given you a CMB prescription form, ask the monitor for one, fill it out with the details of the prescription that the patient needs, have it signed by the preceptor, and return it to the SFSU Pharmacy Team. Please familiarize yourself with this sample CMB prescription form prior to arrival at clinic. The SFSU Pharmacy Team will inform the patient of the details of how to obtain the needed medication and give the patient the signed prescription form.
  • Check with the pharmacy team before your patient leaves to make sure the pharmacy team doesn’t need any more paperwork from your patient and that your patient has received instructions about how to obtain and use their medications.
  • Ask the SFSU pharmacy volunteers if you have any questions.

Lab

  • If the MD preceptor indicates that the patient requires blood, urine, or cytological studies, you will have to fill out lab forms and collect the necessary specimines.
  • There are two types of lab requisition forms: the white form is for blood/urine tests; and the pink form is for cytology. Please familiarize yourself with the sample white lab requisition form and pink lab requisition form before arriving at clinic. Laminated versions of these sample forms will be available at clinic. Blank lab requisition forms will be available from the SFSU lab team volunteers. At the clinic, please fill out the blank forms with all pertinent patient information needed prior to collecting patient specimines.
  • SFSU lab team volunteers will also provide the appropriate tubes and any necessary collecting instructions to the medical student. If your patient will be providing a urine sample, please remember to explain the clean catch method to the patient!
  • Return the tubes and/or urine specimines to the SFSU lab volunteers after collection, they will process the specimens and store them as indicated.
  • If clinic becomes backed up, the medical student coordinator may take over lab procedures and medical student volunteers should continue taking history, pharmacy and referrals.
  • Deadline for lab collection is 3pm sharp!
  • Some samples need to sit for 30 minutes so take your lab ASAP if you are seeing a patient in the afternoon.
  • Ask the SFSU lab volunteers if you have any questions.

Referrals

  • If the MD preceptor indicates that your patient requires services that CMB does not provide, such as dental services, mamograms, opthomologic consults, and etc., you will have to fill out a patient referral form to ensure that the patient can access those services.
  • Referrals forms are available from the SFSU referrals team volunteers. Please click on the links here before arriving at the clinic to familiarize yourself with our most commonly used referral forms: for referrals to SFGH; for referrals to the Lyons Eye Foundation, including the Lyons Eye Foundation patient financial information sheet.
  • Present the completed referrals form to the monitor, who will assign an SFSU volunteer to follow up and ensure that the patient accesses the needed services.
  • Please ask the SFSU referrals team volunteeres about any quesitons you may have regarding how to refer patients for particular services.

SOAP Notes

  • Document the patient interaction in the SOAP note format and have the MD preceptor sign off on it.

Follow-up

  • Fill out a follow-up form if the MD preceptor has indicated that the patient should return to the clinic at a specific time in the future or there is an issue that requires follow-up that is not related to referrals, pharmacy, or lab matters (follow-up regarding referrals, pharmacy, or lab issues will be handled by the SFSU volunteers from the appropriate committee).
  • If a follow-up appointment is necessary, please remember to also inform the patient about when they should return to the clinic.

Return the chart with the completed SOAP note and all other documentation to the monitor once you are done with your patient. Mention any follow-up necessary to the monitors.

SFSU VOLUNTEER ROLES

  • Reception volunteer: greets the patient; makes new charts for new patients; retrieves charts on established patients; keeps resources binder.
  • Intake volunteer: obtains patient vital signs and chief complaint.
  • Pharmacy volunteer: determines the lowest cost and most logistically feasible method of obtaining medications prescribed by MD preceptors; keeps record of formulary meds available; and enrolls patients needing non-formulary meds in DAPs (Drug Assistance Programs).
  • Laboratory volunteer: keeps all phlebotomy and urine sample supplies, completes lab requisition forms on-line, and prepares lab specimens for pick up.
  • Referrals volunteer: submits referral forms to appropriate local providers and follows up with patients to ensure patients are able to access the needed services.
  • Patient Education volunteer: gives focused presentations in the waiting area
  • Clinic Monitor: helps triage, oversees clinic flow and SFSU and medical student activity, orients medical students and preceptors.

SFSU volunteers are the first and the last people in clinic. If free from clinic duties, they may shadow medical students/preceptors and assist in translating for medical students and preceptors.

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