Medical Degree Program Admissions Information for Incoming Students Curriculum Electives Student Experience Student Support 625N - Integrative Medicine This rotation is for UCI students only. Students must obtain permission from the course director prior to enrollment in this course. Home Education Medical Education Medical Degree Program Curriculum 625N - Integrative Medicine Course Director, Coordinator and General Administrative Information Faculty & Staff Office Location Phone Email Director: David Kilgore, MD Bldg 200, Suite 835 Orange, CA 92868 714-480-2443 firstname.lastname@example.org Coordinator: Elaine Chen 200 S. Manchester, Suite 835 Orange, CA 92868 714-509-7863 email@example.com DESCRIPTION This is an outpatient rotation focused on giving students the opportunity to observe the practices of a wide variety of multidisciplinary Integrative clinicians practicing at the Susan Samueli Integrative Health Institute in Costa Mesa and the Integrative Medicine Program at the Family Health Center in Santa Ana. The student role in the clinics includes participating in discussions of the Integrative assessments and treatment plans for patients; depending on the clinic session, judgement of the supervising faculty and patient consent, students may also participate in obtaining histories, performing appropriate physical examinations, and providing Integrative patient education guidance. Students will also complete several online Integrative educational modules, focused journal and textbook readings, and complete a short reflection paper assignment at the end of the rotation. PREREQUISITES Must be a fourth-year medical student. UCI students must have successfully completed the third-year curriculum. RESTRICTIONS UCI students only. Students must obtain the permission of the Elective Director prior to enrollment. This elective is primarily designed for MS4 HEAL-IM program medical students, although it’s open to non-HEAL-IM MS4 medical students as space and scheduling allows. This course does not accept international students nor students outside of UCI. COURSE DIRECTOR David Kilgore, MD, FAAFP is a Clinical Professor of Family Medicine in the Department of Family Medicine at the University of California, Irvine. Dr. Kilgore began his academic teaching career in 1994, with the University of Washington, completing a faculty development fellowship and is serving as residency teaching faculty and as medical director with the University of Washington. He joined the UCI Department of Family Medicine in 2008 to help develop the first graduate level residency PRIME track in the UC system. After completing an Integrative Medicine fellowship from the University of Arizona in 2011, he went on to start a number of Integrative Medicine and health and wellness programs within UCI School of Medicine, including being the Director of the first Integrative Medicine Educational Track within the Family Medicine Residency Program, starting a health and wellness lecture series for 1st- and 2nd-year medical students, serving as course director for the Culinary Medicine elective, Director for various Integrative Medicine patient care resources at the UCI Family Health Center, including healthy cooking classes for the Family Health Center Teaching Kitchen, PI for a collaborative three-year multi-institutional grant to help support the transformation of local Orange County safety net community health clinics towards a model of health and wellness and to be better able to provide Integrative Health care and resources to their underserved communities. He also created the curriculum for the HEAL-IM program (Health Education to Advance Leaders in Integrative Medicine) in the School of Medicine and has served as the HEAL-IM director since the program started in the fall of 2019. Dr. Kilgore is also certified in Medical Acupuncture, and his positions at UCI have allowed him to focus on his passion for increasing access to Integrative Health resources for the underserved communities in Orange County, and in teaching medical students and residents about the importance of incorporating concepts of prevention, health and wellness in the basic healthcare we offer all patients COURSE COORDINATOR Elaine Chen is the course coordinator for the 625N Integrative Medicine Elective course. She has coordinated and directed adult education programs at UCI since 2006, including the HEAL-IM seminar series and Culinary Medicine Elective for UCI medical students, and the Integrative Medicine Track for UCI Family Medicine Residents. INFORMATION FOR THE FIRST DAY Location/Time to Report on First Day: At least two weeks in advance of the rotation, Elaine Chen will send out information about your individual schedule along with other rotation logistics - students are encouraged to reach out with any questions. Generally, white coat, business casual attire, and close toed shoes will be fine for clinic visits SITE: UCI Samueli Institute in Costa Mesa, the UCI Family Health Center, Santa Ana and the UCI Medical Center Integrative Medicine consultation service. DURATION: two to four weeks. The two-week elective is comprised of only rotating through a core subset of Integrative clinics. The four-week rotation includes an expanded rotation experience with the Integrative team, as well as time to complete additional Integrative educational modules. Although the two-week rotation is acceptable to satisfy this curriculum element of the HEAL-IM Program, it is recommended that HEAL-IM track students take the four-week rotation when possible. Scheduling Coordinator: UCI students please email firstname.lastname@example.org to make a scheduling appointment. Periods Available: The time of the course must be pre-approved by the elective director at least three months prior to the start of the course. No exceptions. NUMBER OF STUDENTS ALLOWED: Generally, one per rotation. Two students per rotation may be allowed, if faculty preceptor schedules and clinic space allow it. WHAT STUDENTS SHOULD DO TO PREPARE FOR THE COURSE By end of March in MS3 year: Respond to survey link re: desired dates and alternate availability during the MS4 year, as well as any specific areas of educational interest for the rotation. One month prior to elective: Students taking the four-week elective should pre-register for the HeartMath Biofeedback Training Program in Heart Rate Variability – by communicating with course coordinator Elaine Chen (email@example.com) four weeks before the start of their elective. Students taking the two-week elective may choose to do this if desired. Prior to First Day of Elective: Read this Journal Article: Maizes, V., Rakel, D., & Niemiec, C. (2009). Integrative medicine and patient-centered care. Explore: The Journal of Science and Healing, 5(5), 277- 289. Watch this Video: Chesney, MA (2016, November 16). The landscape of integrative health and wellness in the United States. [Audio recording with PowerPoint slides]. Review this section of the National Center for Complementary and Integrative Health (NCCIH) website: Students should familiarize themselves with the basic definitions of “Complementary, Alternative and Integrative Health” according to the NCCIH. The website has links to many other helpful resources for up to date information about Integrative Medicine that the student is encouraged to explore and refer to during the rotation. COMMUNICATION WITH FACULTY Questions about logistics should be directed to the Course Coordinator. Direct questions, comments, or concerns about the course can be directed to the Course Director. Contact information and office location are at the beginning of this document. The Course Director is also available to meet in person. Please email firstname.lastname@example.org to arrange an appointment. To ensure that your email will not be lost in the large volume of email received, please use the following convention for the subject line: SUBJECT: COURSE NAME, your last name, your issue (e.g. 625N, Smith, Request for appointment) Course Objectives and Program Objective Mapping The following are the learning objectives for the 625N course. Students are expected to demonstrate proficiency in these areas in order to satisfactorily complete the course. In addition, the extent of a student's mastery of these objectives will help guide the course evaluation and grade. Course Objective Mapped UCI School of Medicine Program Objective Sub Competency Core Competency Demonstrate understanding of common categories of Integrative therapies, including their proposed mechanisms, safety/efficacy profile, potential indications, benefits, risks, and contraindications. A-4. Knowledge of population health, epidemiology principles and the scientific basis of research methods relevant to healthcare Population Health and Epidemiology Knowledge Identify health conditions for which an integrative health approach may be beneficial. B-6. The ability to function effectively within the context of complexity and uncertainty in medical care Patient Management Skillful Describe the importance of self-care and provide guidance and education re: healthy lifestyle behaviors. B-5. The ability to practice effective preventive medicine by identifying, addressing and advocating for strategies to maintain health and well-being, to identify and treat disease early where appropriate and to advise on lifestyle practices Patient Management Skillful Demonstrate respect and understanding of patients’ interpretations of health, disease and illness that are based upon their personal cultural beliefs and practices. C-3. Sensitivity and awareness of diverse cultures, health beliefs and social factors impacting patient health and illness Cultural and Social Awareness Altruistic Identify and use validated, evidence based educational and patient care resources that offer guidance on the safe and effective application of Integrative Health practices. B-4. The ability to search medical literature, including electronic databases, and to locate and interpret up-to-date evidence to optimize patient care Evidence-based medicine Skillful Communicate respectively with allied health Integrative practitioners and work collaboratively with a multidisciplinary healthcare team. C-1. Honesty and integrity reflecting the standards of the profession, in interacting with colleagues, patients, families and professional organizations Professionalism Altruistic Course Resources TEXTS AND READINGS: SUGGESTED Reference Textbooks to use during the rotation: Integrative Reference Textbooks: Both are available in SSIHI Clinic Resource Library – students are strongly encouraged to consult them during the rotation to help answer Integrative care questions that come up during the rotation. Textbook of Integrative Medicine, 4th edition, by David Rakel, MD. Comprehensive review of Integrative approaches to a broad array of common clinical problems. National Geographic Guide to Medicinal Herbs, by David Kiefer, MD, Tierona Low Dog MD. Detailed guide to medicinal use of a wide variety of botanical supplements. Online Integrative Resources to use during the rotation: Natural Medicines Database: Accessed through our Grunigen Medical Library https://naturalmedicines.therapeuticresearch.com/ University of Wisconsin Integrative Health Educational Resources – a treasure trove of Integrative teaching resources for clinicians and patients – multiple handouts and videos on wide range of topics related to providing evidence-based Integrative patient care: https://www.fammed.wisc.edu/integrative/resources/ Santa Rosa Family Medicine Residency Integrative Medicine Educational Resources – another treasure trove of so many wonderful resources and guides to providing IM care to patients, especially underserved communities, as well as education for clinicians and self-care and wellness guides. Here’s their general site: https://www.srfmr.org/patienteducation/im-resources/ Here are their IM handouts: https://www.srfmr.org/patienteducation/im-handouts/ and here are even more patient education handouts: https://www.srfmr.org/patient-education/ For Students taking the four-week elective: Two Online Trainings to Complete: Ohio State University Online Training: Herbal and Dietary Supplements Across the Lifespan. For students who have not completed any previous OSU supplement modules, we strongly suggest you complete the 2 Foundational Modules (Introduction to Herbs and Dietary Supplements Across the Lifespan and Safety of Herbs and Dietary Supplements). Students who have previously completed those modules may select any other 2 modules Curriculum and Educational Policy Committee Rev. 3/21/18 7 of their choice to complete. Follow the login instructions on completing each module, you will receive a Certificate of Completion – email a copy of that certificate to Elaine Chen email@example.com to receive credit for module completion. HeartMath Biofeedback Training Program in Heart Rate Variability. This nine-hour course covers the scientific underpinnings of Heart Rate variability including the therapeutic implications of HRV measurement and assessment, the importance of heart rate variability coherence and its role in mental, emotional and physical health. The nine-hour total includes six hours core content plus 90 minutes of in-depth emWave training and 90 minutes of recorded Q&A sessions. The course package includes all necessary software. At the conclusion of the course, you will receive a certificate of HeartMath Clinical Certification, and are able to keep the software for ongoing personal practice. CHECK WITH ELAINE FOR ENROLLMENT INSTRUCTIONS – STUDENTS SHOULD REGISTER 1-2 WEEKS BEFORE THE ROTATION, IF POSSIBLE, TO HAVE THE SOFTWARE AND HARDWARE AT THE BEGINNING OF THE ROTATION. Two Other Online Learning Modules: Required for four-week elective (optional but recommended for two-week elective) from The Andrew Weil Center for Integrative Medicine (modules available without cost) Environmental Health: an Integrative Approach. This is a six-hour module that covers environmental toxicants and the documented rise of complex chronic illness, such as obesity, metabolic syndrome, cancers, neurodevelopmental disorders and reproductive health. Nutrition Above the Neck. Lecture reviewing role of diet and nutrients in brain function and mental disorders. Other Suggested but Optional Rotation Resources Optional Online Integrative Resources University of Minnesota Integrative free online courses: To get started, click the course card that interests you and enroll. You can enroll and complete the course to earn a shareable certificate, or you can audit it to view the course materials for free. When you subscribe to a course that is part of a Specialization, you’re automatically subscribed to the full Specialization. Visit your learner dashboard to track your progress. Guided Imagery (14 hrs) Aromatherapy (17 hrs) Andrew Weil Center for Integrative Medicine (modules available without cost): Introduction to Contemplative Care: Three-hour module designed for those interested in working in hospice care and with end-of-life patients. IM4US (Integrative Medicine for the Underserved): wonderful group of clinicians working to bring Integrative care to underserved communities, together with educating clinicians on the optimal ways to provide Integrative Healthcare to disenfranchised communities. They have toolkits for: IM approaches to pain Nutrition and health Optional Integrative Medicine Journal Readings Spiro, A. & Perlman, A. (2016, August 4). A holistic approach to health care can lower costs and improve quality. Hospitals & Health Networks Magazine. Kligler, B., Teets, R., & Quick, M. (2016). Complementary/integrative therapies that work: A review of the evidence. Am Fam Physician, 94(5), 369-374. Nguyen, C. (2017, January 12). Resident summary of Kligler article on effective IM interventions. Bell, I. R., Caspi, O., Schwartz, G. E., Grant, K. L., Gaudet, T. W., Rychener, D., ... & Weil, A. (2002). Integrative medicine and systemic outcomes research: issues in the emergence of a new model for primary health care. Archives of internal medicine, 162(2), 133-140. doi:10.1001/archinte.162.2.133 Major Exams, Assignments and Grading MANDATORY SESSIONS Session Title Location Integrative clinic assignments See individual schedule MAJOR ASSIGNMENTS AND EXAMS All Students taking elective: End of Rotation One Page Reflection Paper Assignment All students taking the elective must complete and submit a one-page reflection paper in order to receive credit for the rotation. The paper should have two sections: Section 1: A brief narrative overview of educational highlights of the rotation for the student, including anything that the learner found surprising or unexpected. Section 2: Five key educational take-aways or learning pearls that the learner will apply in their future clinical practice. Where possible, reference each pearl with an appropriate reference citation from a journal article, web resource or textbook. For students taking the four-week elective Completion of the following (see information in Course Resource section) OSU Online Training Modules HeartMath Biofeedback Training GRADING Medical Students are graded using the following scale: Honors (H), Pass (P), Fail (F), and Incomplete (I). For further information, please review the Grading Policy. The student’s final grade will be submitted on the standard UC Irvine elective form. If the student fails, the elective a grade of "F" will be permanently recorded on his/her transcript. The student can repeat the course for a second grade. However, the "F" will not be removed from the transcript. You have 30 days from the date of the grade to appeal any aspect of this grade. Please contact your Clerkship/course Director should you have any questions. Requirements for “Pass” To receive a grade of Pass, students must demonstrate successful performance in all of the following areas: Knowledge Patient Care Practice-Based Learning Interpersonal & Communication Skills Professionalism Systems-Based Practice Requirements for “Honors” To receive a grade of Honors, students must demonstrate exceptional performance in all of the following areas: Knowledge Patient Care Practice-Based Learning Interpersonal & Communication Skills Professionalism Systems-Based Practice Grounds for “Incomplete” You will not be issued a grade until all elements of the course have been completed. REMEDIATION Remediation, if needed, will be designed by the course director to suit the issue at hand. Grounds for “Fail”: You will receive a grade of "Fail" if the requirements for passing the course have not been met. Please refer to the Grading Policy for the impact of the "Fail" grade to the transcript.