Brattleboro Memorial Hospital
Brattleboro

A not-for-profit institution, Brattleboro Memorial Hospital provides primary and acute medical care to more than 2500 inpatients each year in its 61-bed facility. Of more than 50 attending physicians on the hospital staff, approximately 20 are primary care related and 30 are specialists. The hospital provides more than $1.7 million in free and charitable care each year. Medical capabilities and programs available at BMH are enhanced by the hospital's relationship with the tertiary care facility, Dartmouth-Hitchcock Medical Center in Lebanon, NH. The hospital complex is located in the southern end of Brattleboro, close to the downtown area, as well as near a small commercial area just off Interstate 91's first exit in Vermont. BMH has a strong tradition of

Brattleboro Memorial Hospitalhosting medical students from UVM, Dartmouth as well as from schools in Massachusetts. The majority of medical students undertaking clinical rotations at the hospital come from Dartmouth medical school, while a significant number are UVM medical students.

Preceptors
A number of physicians associated with BMH actively receive medical students. Their private offices are located either in or near the main hospital facility. They, like the majority of doctors affiliated with BMH, independently rent their offices from the hospital. Offices often are former homes nearby the hospital that have been reconditioned as medical clinics providing home-like settings. With numerous preceptors practicing independently, but associated with and located adjacent to BMH, there are many potential learning environments. Typically physicians practice in their outpatient clinics which include a variety of settings, support staff and clientele. With the hospital nearby, doctors easily follow-up patients who enter the facility as inpatients. All departments of BHS actively encourage medical students to observe and participate in activities.

Physicians who have precepted students recently include the following. During their rotations medical students will work with several preceptors to experience a variety of clinical situations and encounters. Doctors other then the below listed would also be involved with precepting students.
· Lynn Herzog, MD - Pediatrics
· Clifford Langweiler, MD - Family practice
· Thomas Lewis, MD - Internal medicine
· Robert Tortolani, MD - Family practice

Typical Day
Customary activities for the student include:
work up of patient histories, patient examination with the preceptor, patient follow-up, and if the patient is referred to another doctor, the student is invited to the follow-up sessions. Beyond these "typical" activities, "atypical" days are more likely where unexpected opportunities arise. Hospital staff are aware that a medical student is present and make an effort to alert them to situations of unique learning and observing occasions. Additionally, preceptors invite students to accompany and participate with them in their extra-clinical activities. Possible settings other than in the practice clinic include: visits to nursing homes, regular turns at the Center for International Studies health clinic, attending administration meetings (such as negotiating with insurance companies concerning benefits), and emergency room shifts in the evenings.

Teaching Goals
The whole patient and their care is the primary focus of all hospital staff. This is illustrated in the commitment to involve medical students in all aspects of patient care, from first visit to follow-up. Likewise, including students in administrative aspects of running a health care practice reflects a concern for the student to have a well-rounded medical experience. Preceptors seek to provide students with exposure both: to the operation of a small practice; and the management of a modest hospital in a small but sophisticated community. There is a strong emphasis and openness to include students in a variety of learning situations related to in- and outpatient settings. Both doctors and nursing staff invite students to observe and participate in unique health issues. For example, one student was called to the emergency room when a patient was admitted with a complicated laceration. With supervision, the medical student cleaned and sutured the wound, utilizing knowledge learned in the classroom while gaining valuable, real-life skills.

Student Housing
Students are provided rooms in a basement wing of the hospital which provides proximity to the work site as well as optimal opportunity to be involved in unplanned medical activities.

The Community
Brattleboro is situated between the West and Connecticut rivers, with Mt. Wantastiquet to the east and a range of 1,500-foot hills to the west, in the southeast corner of Vermont. By car it is two and half-hours southeast of Burlington and two hours from Boston. The town of nearly 12,000 is named after its former title owner, William Brattle, a colonel in King George II's militia. Brattleboro's economy is healthy and growing, primarily because the town has a diversified industrial and commercial base. The lively downtown area provides a unique cultural setting with 15 galleries, many bookstores, a strong tradition of music and arts, as well as an exceptional variety of community sponsored activities. Likewise, numerous dining and shopping opportunities are available for a community of its size. Norman Crampton in his book, The 100 Best Small Towns in America recently named Brattleboro as the fifth best small town. Brattleboro is known as the "Hub of New England" as it is adjacent to Interstate 91 and its proximity to Massachusetts in the south, New Hampshire in the east, and the recreational areas of the Green Mountains in the west.

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