This post is an overview of a typical day during my Family Medicine rotation. At the end, I’ll also review resources I used to prepare for the Family Medicine NBME shelf exam. Feel free to email me at firstname.lastname@example.org with questions, or leave a comment below!
Wake up, get dressed, and leave the house by 7AM. I usually picked up coffee on the way since I had a 45+ minute commute.
8:00AM – 9:00AM
Morning report. The residents and the attending came together every morning to discuss the patients that are currently under their care in the hospital. The overnight team, usually a second or third year resident plus an intern, also goes over any new admissions or changes overnight. The cool thing about family medicine is that there is so much variety! The discussions ranged from how social workers can help a homeless patient with schizophrenia to end of life care and pain management for a woman with advanced cervical cancer.
Towards the end of morning report, one of the residents or a medical student would have a 5-10 minute presentation on a topic of their choice. Some of the topics covered were Zika virus, management of diabetes, and differential diagnoses for cough. Many of the topics were based on articles from AAFP, which stands for the American Academy of Family Physicians. They have new articles come out twice a month, with reviews and recommendations for updated practices. You can also sign up for their Board Review questions for free! (Skip to the end of this post to read about what I thought of those questions).
9AM – 11:30AM
After morning report, the resident on Community/Geriatrics and the medical students go to one of the nursing homes that are under the care of the practice. We were able to interview the patients on our own and do a physical exam (as much as could be tolerated by the patient) before presenting to the resident. The resident would then go in after us and ask more focused questions such as, “how is your sleep after starting the new antidepressant?” Some of the residents had advanced dementia and so working with them was a challenge for me. It took until the middle of the rotation for me to feel more confident in interviewing geriatric patients, and I am very grateful for such a great learning experience.
11:30AM – 12:30PM
After the nursing home we would go back to the office and either see patients with the residents or use the downtime to study. I usually opted to work with a resident so I could practice my physical exam and interview skills, but as it got closer to shelf time I chose to study.
12:30PM – 1:30PM
The middle of the day was reserved for lunch and reviewing patients that would be seen in the afternoon. The office was awesome and ordered food for everyone, including medical students, which was greatly appreciated!
1:30PM – 5:00PM
Afternoons were spent seeing patients with residents. Our responsibilities as students varied depending on the resident we were working with. Some preferred you to go in first and get started taking a history, while others went in with you and evaluated the patient together. After the visit, the resident would review the visit with you and go over the plan before presenting to the attending physician. One of the most useful things I learned on this rotation was a proper presentation of a patient. It came with practice and lots of feedback from the attendings.
The day finished around 5-5:30 usually, and I would be home by 6:30. I did my best to try to study but most of my studying was done on the weekends.
Resources used for Family Medicine NBME shelf exam.
*Please keep in mind that these are my opinions and what worked for me*
Case Files Family Medicine
I thought this was by far the best resource, although to be fair there are fewer dedicated resources for this shelf than others. For students who are not familiar with the series, Case Files walks you through 60 cases on commonly tested subjects in each subject. Family Medicine is said to be a difficult shelf exam, especially for students who have it earlier in the year. I thought Case Files did a good job covering a little bit of everything, and their charts were helpful. Some of their explanations were dense and had to be read a few times before I remembered them all. I tried to do 2 cases a night before going to sleep just so I wouldn’t have to cram everything in the end.
Step Up to Medicine 4th edition
This book is usually recommended for the Medicine shelf but the Ambulatory and Derm section was clutch. The sections are not very thick so I looked over them a few times before the shelf, and I’m glad I did because there were definitely more dermatology questions than I expected.
I only did the 40 or so Dermatology questions on UWorld. I’ve heard that some students use the Medicine questions but I chose not to because I was doing the AAFP questions.
AAFP Board Review Questions
I did about 500 questions and now that I’ve taken the shelf, I don’t know that I would do them again. They are designed for residents in Family Medicine and so a lot of the questions were beyond the scope of what was needed for the NBME shelf exam. For material that was relevant for the shelf, I had already studied it from Case Files or Step Up. If you’re looking for extra study material, it’s not bad for reinforcing what you know but I wouldn’t prioritize them over Case Files or Step Up.
The US Preventive Services Task Force has a list of A and B recommendations posted here that were helpful, since a large part of Family Medicine is preventative care. It seems like a long list but trust me, you know more than you think.
Thanks for reading!