Otter Creek Family Health Center
Brandon, VT

Otter Creek Family Health Center
The Otter Creek Family Health Center is an independent and solo physician family practice facility. Housed in a home, the health center presents a comfortable, friendly and pleasant environment. The physician and owner of the practice, Dr. Fjeld, has admitting privileges at Porter Hospital, to the north of Brandon. The clinic includes six examination rooms, a small procedure room and lab. Patients seen at the clinic range from newborns to 92 year old people and exhibit a wide variety of economic backgrounds and medical conditions.

Porter Hospital
Located in Middlebury, Porter Hospital is a 45-bed community hospital providing 24-hour emergency services and comprehensive medical care. The facility has served the local communities since 1925. Special programs and facilities found provided at the hospital include: CT scanning and MRI technology; a variety of health education programs for the entire family and courses for expectant parents; a breast health resource center; and a cardiac rehabilitation program.

Staff
Staff at the Otter Creek Family Health Center includes two Nurse Practitioners, two nurses and administrative personnel. Dr. George Fjeld, with special interests in pediatrics and preventive medicine, provides training and educational opportunities for medical students. The entire center staff are supportive of medical students and proactive in including them in learning and skill practice situations.

Typical Day
The focus of the student's learning experience is predominantly located within the office-based clinical setting. Patient rounds at Porter Hospital occur once or twice a week in the morning. Friday mornings are grand rounds at Porter Hospital. A day in the clinic typically runs from 9 to 5, with evening hours on Monday until 9 p.m. for "on-call" hours and patients unable to come in during normal working hours. Cases seen in the clinic represent a wide spectrum of complaints which provides many learning opportunities.
Students are brought into the full patient examination and assessment process of through stages. They initially accompany the preceptor for patient history taking and work towards independently interviewing and diagnosing patients and developing tentative treatment plans. The student follows up each patient they have seen with the physician to provide a concluding diagnosis and recommended treatment plan. The preceptor selects patients for the student who need diagnosis. The patient population is open to and encouraging of students in their rotation experience. As well as diagnosis, there may be opportunities for conducting procedures such as wrapping and dressing, and stitching. Opportunities for inclusion in local family and community activities are also integrated into the rotation experience by the preceptor.

Teaching Goals
Overall, a fundamental objective of the rotation experience is for student exposure to the range of clinical activities in which a family practice physician engages. In this setting, the Preceptor emphasizes efficient history taking and relevant physical exams. There is also particular encouragement on critically thinking through the "what and why" of diagnosis and treatment options. A focus is also placed on improving interpersonal skills with patients, especially those of effective data gathering, assessment and feedback. An additional goal is to demonstrate the necessary integration of a physician's medical practice within the context of local communities and families. In all these teaching goals, the preceptor seeks an unhurried and positive learning environment.

Student Housing
Housing in the Brandon area is available and arranged as needed.

The Community
Shortly after being chartered in 1761, Brandon became an important saw and grist mill town. Abundant local iron ore led to the production of stoves and other iron products. With the arrival of the Burlington-Rutland Railroad in 1849, Brandon was an important center for the manufacture of railroad cars. It was also a major marble quarrying area. During these boom years, many fine homes were built and are still occupied today. In the middle 1800s town leaders were involved in the Underground Railroad movement.

The town's layout is unique with two village greens and the Neshobe River flowing between them. The entire village of 243 buildings is listed on the National Register of Historic Places. Interspersed among the attractive and historic homes are many eateries and shopping opportunities. The town is situated in the foothills of the Green Mountain National Forest and close to Lake Dunmore and Lake Champlain. Brandon is located twenty miles north of Rutland and approximately fifty-five miles south of Burlington. Residents claim that the weather in their area is warmer, sunnier and more pleasant than the rest of the state!