After years of preparation, the Foundations in Clinical Medicine (FCM) course has successfully completed its inaugural year as part of the UVA School of Medicine curriculum. It’s gratifying to know that FCM has been well-received by both faculty and students.
What is FCM?
FCM is a four-year, longitudinal course led by physician coaches and non-physician co-mentors. FCM1 spans the first 18 months of medical school and covers physical diagnosis, history taking, clinical reasoning, professional identity formation, and well-being practices. FCM2 extends this training through the final two years of medical school.
An important goal of FCM is to prepare future physicians to make wise decisions through critical reasoning. Among other things, it trains our students to avoid oversimplifying situations, reflect before making decisions, and continuously learn from their experience.
How is FCM different from other courses? Here are a few highlights
Daily Classroom-to-Clinic Learning: The practice of medicine — both the science and the art — is the focus of FCM. After participating in morning learning activities, students spend their afternoons in FCM1 applying that knowledge in clinical settings.
Continuous Coaching: Students are matched with a coach for all four years of medical school. This allows us to standardize our approach to teaching skills like clinical reasoning. FCM1 students meet with their coach once a week, and coaching continues on a quarterly basis in FCM2.
Focus on Personal Wellbeing: FCM offers compassion training and teaches skills like the STOP technique (Stop. Take a breath. Observe. Proceed.) that help our students sustain their own well-being.
Physical Exam Practices: We have a renewed focus on teaching our students how to perform the physical exam, using the latest evidence and the best techniques. In a world where many doctors eschew listening to a patients’ lungs in favor of ordering a chest X-ray, we want to move toward not teaching every exam maneuver available, but rather choosing evidence-based methods that help in medical decision-making.
Financial Awareness: FCM trains students to be aware of the financial impact that medical testing can have on patients. When ordering tests, we teach them to share decision-making with patients and to take their financial circumstances into consideration.
Student Testimonial: I learned from being “stumped”
While being observed by a master assessor, a third-year FCM2 student struggled to complete a history and physical (H&P) exam on a challenging patient. The student received immediate, constructive feedback from the assessor and also discussed the experience with her coach.
The student quickly applied the feedback and noted that it was worth getting stumped with a hard case because the assessor’s feedback proved to be one of the student’s most valuable learning experiences.
Looking ahead, we expect that students who participate in FCM will move into their clerkship year with sharper clinical decision-making skills and a better ability to see “the big picture” impacting their patients. Personally, I look forward to seeing our FCM students evolve into effective clinicians who easily establish rapport with patients, consider their perspectives, openly communicate with them, and advocate on their behalf.
After all, aren’t those skills you want your doctor to have?
R.J. Canterbury, MD, MS, DLFAPA
Wilford W. Spradlin Professor
Senior Associate Dean for Education
Filed Under: Education