Course Orientation for Clinical Rotation in Integrative Medicine

Academic Year 2007-2008

TO: Students Participating in the Integrative Medicine Clinical Elective (EM 495)

FROM:  

• Daniel A. Monti, MD, Course Director and Brind Center Director
• Edwina Benson, Assistant to Dr. Monti and administrative contact
• Birgit Rakel, MD, Family Medicine and Integrative Medicine physician, primary physician contact
• Joel S. Edman, DSc, Clinical Nutritionist and Associate Research Director, primary non-physician staff contact

RE: Course Orientation

Welcome to the Integrative Medicine Clinical Rotation.

1. The clinical practice of the Jefferson Myrna Brind Center of Integrative Medicine is located in the Gibbon Building, Suite 6215. The phone number there is 215-955-2221.  Dr. Monti’s and Edwina Benson’s number is 215-955-4410.  Call Edwina Benson prior to the rotation for specific instructions about where and when to show up on the first day. You will begin with a 30 minute meeting with Dr. Monti, the course director.  This will be followed by a 60 minute meeting with Dr. Edman who will further orient you to the rotation.  You will also spend the next day, Tuesday (and Tuesdays and all Tuesdays for the rotation) with Dr. Rakel who is the primary physician contact for the rotation.
   
   This practice supports over 8500 visits annually. Full and part-time staff includes: 7 physicians, 2 acupuncturists, 2 massage therapists, 1 PhD level clinical nutritionist, 2 psychologists, 2 nurses, and 3 meditation teachers. Typical treatment plans “integrate” conventional medicine with complementary therapies such as therapeutic diets, nutritional supplements, herbal medicines, homeopathic remedies, acupuncture, massage, Mindfulness-Based Stress Reduction, and others.

2. Because of the nature of this practice, students will generally accompany the physician or therapist during a patient encounter, rather than performing independent, extensive evaluations of patients. Another requirement is to write up a case report describing a patient’s integrative medicine treatment plan at the Brind Center.

3. You are required to wear your ID; white coat is optional.

4. Reading: We will help guide your reading throughout the rotation. To begin with:
   
   
   • During the first week, begin to peruse Rakel’s textbook of Integrative Medicine. A hard copy is in the office, and it is also online through MD Consult.
     
   • Download Mobile Micromedex to your PDA. It is free through JEFFLINE. It includes an alternative medicine database.
     
   • Spend time on the NIH National Center for Complementary and Alternative Medicine website at: http://nccam.nih.gov
     
   • Check out the resources section of the Brind Center academic website as well as other information that is provided: http://jeffline.jefferson.edu/JMBCIM/resources.html
     
     
5. The following is your schedule for the Integrative medicine rotation:

• Mondays – spend with Ian Cyrus, MS, RAc (also a good day for projects)
• Tuesdays – spend entire day with Birgit Rakel, MD
• Wednesdays – spend entire day with David Capuzzi, MD, PhD
• Thursdays – split between Betina Herbert, MD and Jingduan Yang, MD
• Fridays – split between Anthony Bazzan, MD, and Joel S. Edman, DSc

If more than one student is on rotation, it is recommended to coordinate scheduling.  We will also try to have the schedule for the last week of the rotation be more flexible so that you might be able to spend more time with practitioners and areas that you are more interested in.

The main physician faculty include Birgit Rakel, MD (Family Medicine), David Capuzzi, MD, PhD (Endocrinology and Lipid Specialist), Anthony J. Bazzan, MD (Internal Medicine) and Bettina Herbert, MD (PMR).   If a practitioner is away or if there are any problems or questions with the schedule, the practitioner schedule below should help you to effectively adjust your schedule. 

In addition, we have other staff with whom you should connect:

1. There are two psychologists on staff at the clinic. Although you may not be able to see patients with them, they are available for conversation about non-mainstream approaches they use. They are: Anna Tobia, PhD (aetobia@yahoo.com); and Patricia Coughlin, PhD (drpcoughlin@gmail.com). 
2. We have a well established Mindfulness Based Stress Reduction (MBSR) program with which you should become familiar.  Some information can be obtained from the hospital and academic websites.  Also, contact Diane Reibel, PhD, the MBSR Director of Education and Development to set up a meeting (dianereibel@jefferson.edu)
3. Doreen Lafferty is one of our massage therapists.  You should make an appointment with her for a FREE massage and at that time she will describe some of the approaches that she uses.  Some students schedule this at the end of the rotation but this can be done at any time.
4. There is a yoga program at the Brind Center directed by Dr. Pratap and he runs a wellness selective from October to February that includes classes that you may attend.  Please contact his assistant and yoga instructor Barbara Levitt (yogasearch@aol.com) to see if you may attend a class or two of the Wellness Selective, or if there are other ongoing classes that you might attend.

6. Integrative Medicine Grand Rounds and Clinical Conferences: The Center has a Grand Rounds lecture and a clinical case conference once a month on a Friday morning at 8AM. Please find out the schedule for the month you are on and ATTEND THEM.

7. Web-based nutrition projects you are required to complete are:

(a) a web-based module on  an anti-inflammatory diet during the first 2 weeks of the rotation. http://dime.arizona.edu/nutrition/ai.  You will be prompted to log in. Username: nutai_jefferson Password: dietright; and

(b) a one-day food record at fitday.com.  Log into the website, enter a one day dietary record and it will provide you with a nutritional analysis.

Additional online learning: (c) View at least three previous Brind Center Grand Rounds lectures.  They are listed on our academic website under Education and Grand Rounds lectures. Also, review the didactic modules on the academic website. 

8. Review the list of nutritional supplements that may be recommended to patients – there is a notebook that has a print out of each product.  Have a general understanding for what the supplements are recommended for.  Also, visit the Jefferson Pharmacy at 908 Walnut Street, where you can see the products that are recommended and get additional information.  
   
   
9. Personal Wellness Requirement. It is a core requirement of the rotation for you to define a personal wellness goal for the month. This means adding a new health behavior to support your overall wellness. Possibilities include making a healthful change in diet, starting a new exercise program, or beginning a new mind-body practice such as meditation or yoga. It is required that you submit a daily activity log at the end of the rotation.
   
   
10. Honors. To qualify for honors you will need to complete a special project. (This is a necessary part but not sufficient criterion for honors). Please speak with Dr. Monti if you would like to do this.
    
    
11. SUMMARY OF TASKS FOR WEEK 1 OF THE ROTATION:

√ Plan and have approved your personal wellness project.
√ Read first chapters of Rakel’s Integrative Medicine.
√ Download Mobile Micromedex to your PDA for its alternative medicine database.
√ Plan ahead to complete the web-based nutrition module and dietary analysis.
√ Spend time on the website for the NIH National Center for Complementary and Alternative Medicine.

12. You must complete a rotation evaluation form and turn it in during the last week of the rotation.

13. Integrative Medicine contact information:

1. Dr. Monti and his assistant, Edwina Benson: 215-955-4410
2. Birgit Rakel, MD: 215-955-2984; birgit.rakel@jefferson.edu
3. Joel S. Edman, DSc: 215-955-2839; joel.edman@jefferson.edu