Skiing Injuries and Family Practice

Sites: VT
Director(s): Joseph Crocker
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time for one month. Offered only in January, February, March.
Location: OTHER - Other U.S. Institutions (40)
Open to Exclerks: No (HMS only)
Description: Students may add themselves to the waiting list for this course during add/drop periods but not during lottery periods. Prior approval required, please email Megan Eichhorn, meichhorn@carlosotisclinic.org, forward approval to registrar@hms.harvard.edu. This course takes place at The Carlos Otis Stratton Mountain Clinic, Stratton Mountain, VT. The clinic is staffed by two volunteer physicians, an orthopaedic surgeon and an internist or family practitioner each week from late November through mid-April. There is a clinic secretary and a staff of experienced nurses, as well as EMTs from the Ski Patrol. Two students are accepted per month) and are expected to be integral members of the staff, helping to assess and treat patients as well as lending a hand with clinic operations. On a busy weekend we may see 40+ patients in a day with trauma, plus medical emergencies such as cardiac arrests etc. We are fully able to care for cardiac patients and all medical staff and RNs have taken ACLS. Drugs, IVs, airway support, and defibrillators are available. On the orthopaedic side, the student will become skilled with the history, physical exam and X-ray assessment of a wide variety of musculoskeletal injuries. Many of the fractures and dislocations are definitively treated and immobilized. Serious injuries requiring hospital care or evaluation (CT MRI) are sent by ambulance to Bennington, Rutland, or Hanover. Life-threatening injuries are sent by helicopter to Hanover. On busy days 3 or 4 ambulance runs are the norm. The students and physicians carry radios so that they may ski, but be available when needed in the clinic. There is no call schedule per se, students are expected to be available daily from 8:30 to 5 or so. Most "graduates" from this clerkship have found it to be a busy and stimulating time while being also able to enjoy the facilities at one of New Englands premier winter sports resorts.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Basic science in anatomy, mechanism of injury, etc are fundamental to assessment of musculoskeletal injuries. Evidence-based medicine is integrated into the student-physician patient discussions.
Grade Criteria:
Honors with Distinction: The outstanding student who recognizes knowledge deficits and rectifies them without prodding. He or she can use their knowledge base to arrive at a viable diagnosis on unfamiliar conditions. Honors: The student who is interested, hard-working and just a notch below high. Satisfactory: Requires some prodding and doesn't always give evidence that he or she has studied up on yesterdays patients. Unsatisfactory: The student who "is along for the ride" and is unwilling to be an active member of the team.