Transitioning

Hello readers!

Today I'm feeling wistful about the coming year and especially about seeing my first round of out-patients as an intern so I've decided to touch on clinic requirements and the experience of the Palmer Clinics.

Mentors
As an intern at the Palmer Clinics, I have a mentor. My mentor, Dr. Beres, is the primary instructive person for me and about 10 other interns. We come in on rotating shifts, though, to get the largest portion of her time possible. This system actually makes everything much easier. In the past, interns would have to chase down doctors who floated from place to place within the clinic. Now, the only person who ever needs to sign my papers or approve my work is my specific mentor. In 8th quarter, students have a meet-and-greet with these clinic mentors and are able to choose one based on that doctor's specific practice model and philosophy. There are a wide variety of doctors available, so choose wisely!

So many numbers!
At the Palmer clinics, a spreadsheet of requirements for graduation will become your best friend. While this has changed slightly over the last couple of years, the idea has remained the same: 25o patient encounters and 1025 hours of clinic time to graduate. Beyond this, though, there are a myriad of other numbers that are sometimes not discussed on tours or on the website because they are specific and complicated enough to cause a lot of nervousness. Let me break these down for you and give you a sense of how your time in clinic will be spent.

• 250 patient encounters (200 must be non-students, 75 must be observed and assessed, 200 must contain a spinal manipulative technique, 30 must include a non-adjustive therapeutic such as ultrasound or rehabilitation exercise)
• 25 Case Management Reviews (completed on new patients with your specific mentor)
• 15 different case types (according to diagnosis and management)
• 30 assessed radiology encounters (up to 13 of these may be assists, meaning the intern will be the assistant to another intern who ordered the films)
• 1025 hours in the clinic minimum
• 10 cases of high complexity (live)
• 20 cases of high complexity (simulated)
• 55 clinical labs/diagnostic studies (25 urinalysis, 20 hematological, 10 chemical cultures)

So those are the numbers... now before your head starts spinning off, remember that while seeing 250 patients, most of these things will just happen naturally. In a population of 250 people, at least 10 of them will be complex... in fact, most of them will probably be "complex" it's just up to you to write up the paperwork. If, however, you find yourself in a position where one of these requirements is not filled, there are a few other options to consider.

Outreach Clinic
Palmer has set up three clinics outside of our two normal outpatient clinics meant to provide a valuable service to struggling members of our community. These clinics offer no-cost service to a variety of people from different socioeconomic levels. It's fantastic for them, but it's also fantastic for us because these clinics are BUSY. At any time during 10th to 13th quarters, interns can go out to one of these clinics, portable table in hand, and start lending a hand. These patients tend to have more complex problems, which makes them ideal candidates for "case of higher complexity" and "radiography candidate" titles.

Clinic Abroad
One of the fantastic opportunities Palmer students have is the ability to go into developing countries and deliver care. Between quarters 10 and 13, students from all three campuses come together for several weeks and have a chance to hone their skills. Not only do students develop better manipulative skills on these trips, but they have a chance to practice a myriad of primary care procedures since many of the patients have never seen a doctor before. Because our care is so rare and valuable to these people, students who elect to attend clinic abroad typically finish the remainder of their 250 encounters during the trip. In my opinion, this is a side bonus to the fantastic work of assisting those who are in desperate need of medical attention.

Once you've finished up these numbers...
You're ready to graduate....or go on preceptor. The preceptor program is available to students in 13th quarter who have finished all their clinic requirements by the middle of 12th quarter. On preceptor, the student can choose from dozens of doctors located all over the country and globe, and practice in that doctor's office for the last three months of their Palmer career. These internships are invaluable since many students find their jobs this way. It's also a great way to see what practicing in a different type of office is like. While the Palmer Clinics are a great educational tool, seeing a private practice in action is a totally different experience, and one that I think is incredibly valuable.

Day to Day of Clinic Life
The first time I went to visit the clinic during 9th quarter, I was completely overwhelmed. There were interns all over the place, papers almost flying through the halls, and door after door of patient rooms, treatment bays, and complex machinery. I could barely believe that I would ever adjust to its layout and intensity. Soon, though, the hallways became familiar, the people recognizable, and the machines operable. So the bottom line is to spend as much time as possible in the clinic before it is required. With the right attitude, and a little work, the experience of an intern should be a lovely journey of discovery: every day, taking one step forward toward becoming someone who can be trusted with patients' health.

Good luck to all of us! :)