Family Medicine Clerkship Student Projects

These projects were completed by students in the University of Vermont Family Medicine Clerkship. Block Clerkship Projects were completed during a five-week period, while Longitudinal Clerkship Projects were completed over the course of a 12-month longitudinal clerkship.

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Bridging the Gap in Mental Health Training of First Responders

Tyler Hastings
Short-term Project
Recent studies have identified a mismatch in the amount of training first responders receive regarding the evaluation, treatment, and transport of patients with psychiatric conditions.

Therein lies the need institute a training system of first responders to include topics of mental illness.
Addressing the Language Barrier

Steven M. Hepp
Short-term Project
There is never enough time for patient education during office visits, this is especially true when using a translator service. Digital resources in many languages could now help improve patient education and outcomes.
The Silent Shift: Making Sense of Perimenopause and Menopause

Mikayla N. Howie
Short-term Project
This community health project explores the spectrum of menopause, focusing on the often overlooked transitional period of perimenopause and the long-term impact of postmenopausal changes on brain health. Through interviews with experts in reproductive health and infertility, cognitive psychology, and the patient perspective; this project highlights major education gaps and opportunities for early intervention. A two-pronged approach was implemented by providing relevant education on both breast cancer risk related to HRT and menopause-associated cognitive decline, empowering patients to make informed decisions about their health during this transition. The goal is to increase awareness, promote proactive counseling, and advocate for more inclusive, lifespan-informed health practices.
Stay Steady: Medications and Fall Prevention for Older Adults

Syed Jafri
Short-term Project
Falls related to medication use are a significant public health concern among older adults, resulting in substantial morbidity and healthcare costs. This community health project involved creating an educational pamphlet targeted to older residents of New Milford, Connecticut, outlining common medications known to increase fall risk and providing medication-specific strategies to mitigate these risks. The pamphlet highlighted drug classes such as antihypertensives, sedatives, opioids, and antidepressants, and offered practical advice, such as slow position changes to reduce orthostatic hypotension. The intervention aimed to increase awareness, promote safer medication practices, and ultimately reduce falls, injuries, and associated healthcare utilization in the elderly population.
Understanding Provider Awareness of Sex Trafficking: Prevalence, Identification, Resources, and Documentation Practices at CVPH Family Medicine Center

Caroline L. Johnston
Short-term Project
This study aimed to assess the knowledge of healthcare professionals at the CVPH Family Medicine Center in Plattsburgh, NY, regarding the prevalence of sex trafficking, available resources, and documentation practices to ensure the safety of trafficking victims. Previous research has shown that over 60% of trafficked women interact with a healthcare provider while in captivity. Participants completed surveys before and after an educational intervention to measure changes in understanding. An in-person educational session was conducted for medical residents, while other healthcare staff received paper-based materials. Results demonstrated a clear increase in knowledge related to the prevalence of sex trafficking, identification of victims, resource provision, and safe documentation practices within the electronic medical record (EMR).
Concussion Reporting and Education: A Public Health Intervention

Nick Jowkar
Short-term Project
Abstract

Introduction:
Concussions are a common and serious injury in high school sports, yet underreporting remains a major barrier to timely diagnosis and care. Many student-athletes continue to play through symptoms due to poor understanding of risks or fear of letting down their team. Schools often lack standardized concussion education, especially in areas without robust athletic trainer (AT) support.

Methods:
This project developed and distributed an educational brochure aimed at student-athletes to improve awareness of concussion symptoms, risks, and the importance of self-reporting. The brochure was shared with local high school ATs, who were invited to complete a brief survey evaluating the current state of concussion education at their schools and their impressions of the brochure.

Results:
Of the 15 ATs contacted, 2 responded. Both reported that their schools do not offer formal concussion education. They rated their confidence that athletes understand concussion risks at 4 out of 5 but acknowledged encountering reluctance to report symptoms (3 out of 5). Both ATs indicated “Maybe” when asked if they would distribute the brochure, whether they felt it would help students better understand concussions, and if they would like additional resources.

Discussion:
Though limited in scale, the results highlight gaps in concussion education at the high school level and suggest interest in accessible tools like brochures to support ATs in delivering key information.

Conclusion:
This brochure is a small but practical step toward empowering student-athletes with knowledge and promoting safer reporting behaviors in sports environments lacking formal education programs.
Gender-Affirming Care Signage Pilot

Arya P. Kale
Short-term Project
In Vermont, LGBTQ+ adults are more likely to delay health care access than non-LGBTQ+ Vermonters. This project seeks to signal a comfortable and safe space at the South Burlington Family Medicine clinic to increase access to primary care for local trans- and gender diverse patients seeking gender affirming care.
Xylazine Test Strips: Harm Reduction in Chittenden County

Ruja Kambli
Short-term Project
Most opioid use disorder resources in Vermont are concentrated in Burlington. This project focused on harm reduction pertaining to the increase of xylazine-related fatalities in recent years. An educational brochure containing local test strip locations was created for the TCHC community and test strips were given to the office to raise awareness surrounding the opioid epidemic and the dangers of xylazine.
Assessing Patient Comfort when Discussing Mental Health Topics with Primary Care Providers

Kristin Karpowicz
Short-term Project
Mental health concerns, including anxiety and depression, remain critical public health issues. However, the extent to which individuals feel comfortable discussing these topics with their primary care providers (PCPs) varies by community. This study assesses the comfort levels of New Canaan, Connecticut, residents in discussing mental health issues with their PCPs and explores their awareness and use of third-party online platforms for obtaining prescriptions. A short electronic survey was distributed in a primary care clinic, with a subsequent paper survey to increase participation. Findings indicate that most respondents (75%) prefer in-person appointments for mental health discussions, and half have spoken to their PCP about anxiety or depression. Comfort levels were influenced by age, gender, and income, with older individuals and females reporting greater ease in discussing mental health concerns. Awareness of online prescription services was low, with only 14.3% of respondents having used such platforms. The study highlights the need for PCPs to initiate conversations about mental health and adapt their approach to patient preferences. Despite limitations such as a small sample size (n=20) and recruitment challenges, the findings offer valuable insights for improving mental health care accessibility in primary care settings. Future research should explore broader population samples and alternative recruitment strategies.
ADHD Diagnosis in Adults: When to Refer to a Specialist

Nicholas Q. Khoo
Short-term Project
Androscoggin County, Maine, faces a critical shortage in behavioral health care access. With a ratio of one primary care physician per 855 patients and one psychiatrist per 11,625, the need for accessible mental health services is urgent. The recent closure of Community Clinical Services (CCS) at St. Mary’s Hospital—one of the region’s primary psychiatric care providers—has further strained the system. Remaining facilities such as Central Maine Medical Center, Sweetser, and Spurwink are now experiencing increased demand, often resulting in months-long wait times for appointments.

A significant portion of behavioral health referrals in the area are for Attention-Deficit/Hyperactivity Disorder (ADHD), a condition that can be diagnosed by a patient’s primary care provider. However, providers may lack confidence in making this diagnosis independently, contributing to unnecessary specialist referrals and delays in care.

To address this gap, a pocket-sized reference booklet was developed to support providers in diagnosing ADHD. The booklet outlines the diagnostic process and includes key questions to help differentiate ADHD from other conditions with overlapping symptoms. The goal is to distribute this resource to clinics throughout Lewiston and greater Androscoggin County, empowering providers to make timely, accurate diagnoses and ultimately improving access to behavioral health care in the region.
Bridging the Gap Between Milton Seniors and Community Resources

Sulekha Kilas
Short-term Project
Patient Education: Colorectal Cancer Screening

Grace Kim
Short-term Project
Colorectal cancer is the third most common cancer in the world with good prognosis if treated early, making routine screening essential. However, patients show reluctance to getting colonoscopies due in part to barriers in healthcare literacy, communication, and procedure discomfort.
Improving Access to Exercise in Rural Vermont

Oliver Karl Koch
Short-term Project
Residents of Essex and Orleans Counties face elevated rates of obesity and comorbid chronic diseases. This is at least in part due to lack of physical activity, which is complicated by exercise resources, harsh winters, geographic isolation, and high poverty rates. This project aimed to improve exercise accessibility by enhancing an existing patient education handout. Revisions included simplified language, seasonal activity suggestions, and exercise modifications for different fitness levels.
Maintaining Muscle Mass on GLP-1s

Sarah Krumholz
Short-term Project
Many patients using GLP-1 receptor agonists for weight loss or diabetes management experience a reduction in both fat and muscle mass. While weight loss can have significant metabolic benefits, the accompanying loss of muscle mass can lead to decreased strength, functional impairment, and long-term health risks. This project aims to address this gap by providing accessible, evidence-based resources to help patients maintain muscle mass through targeted nutrition and resistance exercise strategies.
Understanding Antibiotic Stewardship in the Outpatient Setting in Burlington, VT

Anna Landis
Short-term Project
There are more than 230 million antibiotic prescriptions sent annually to pharmacies in the United States, and more than 28% of outpatient prescriptions are not necessary. This leads to antibiotic resistance and increased healthcare cost. To mitigate this risk, antibiotic stewardship aims to correct provider and patient behavior to ensure that the right drug, at the right dose, for the right duration and the right indication are prescribed. This project focused on community perspectives on this issue as well as provided resources to a local community health center for patients and providers on information regarding common infections and when antibiotics should be utilized.
Colorectal Cancer Screening Options Made Simple

Joon Young Lee
Short-term Project
Colorectal cancer (CRC) is a leading cause of death from cancer and one of the most common cause of cancers in men and women in the U.S. and worldwide. The USPSTF now recommends screening for CRC beginning at age 45. Studies have proven that increasing screening rates can significantly prevent new cases and reduce the number of deaths from CRC. Screening programs and outreach interventions have been successful in increasing patient participation rates and subsequently in reducing CRC incidence and mortality. This project aims to collect and utilize public recommendations and experiences to create a standardized communication in the electronic medical record in the form of a dot phrase as a method of intervention that provides express education on the available CRC screening tests to patients as a means of improving screening rate.
Generating Language for an Electronic Medical Record Patient Deliverable on Lifestyle Approaches to Migraine Prevention

Jonah Levine
Short-term Project
This project aimed to generate language on evidence based lifestyle modifications for migraine prophylaxis to be integrated into the Cerner EMR system at Central Maine Medical Center Family Medicine Residency such that it is made available for clinicians to deliver to migraine patients during an office visit.
Patient Education of Non-operative Management of Hip and Knee Osteoarthritis

Christopher Lin
Short-term Project
Arthritis is a group of diseases that causes joint pain and requires long-term management. 22.5 million adults in the U.S meet criteria for osteoarthritis. 92% of these patients see their primary care physician for OA. Yet, only 6-25% receive care from a specialist. As a result, there is significant patient confusion regarding diagnosis, prognosis, management, and prevention, as well as a lack of understanding of treatment options. Patients have consistently indicated the desire for more information delivered clearly from multiple sources of health information. More effective communication strategies and visual aids are required
Encouraging STI Testing in Clinton County

Jasmine Liu
Short-term Project
Promoting Muscle Health During GLP-1 Therapy Through Nutrition

Erin Manogaran
Short-term Project
The widespread use of GLP-1 receptor agonists for weight loss and metabolic disease management has raised concerns about unintended loss of lean muscle mass, often resulting from reduced overall caloric and protein intake. This decline in muscle mass may contribute to physical weakness, increased risk of falls, and greater susceptibility to other chronic conditions. To address this concern, a patient-centered weekly sample meal plan was developed in collaboration with the clinic dietitian, offering a starting point for individuals to set nutrition goals that support muscle preservation during GLP-1 therapy.
Minimizing Unnecessary Absences from Rural Early Childcare

Elizabeth Medve
Short-term Project
Access to rural childcare can be a significant challenge, and has a significant impact on early childhood development, parent and family employment, and the local economy. Previous studies have demonstrated childcare centers often unnecessarily exclude children from care for mild illnesses, many parents fear losing pay or their job when they stay home with a sick child. In this project, a pamphlet summarizing current guidelines for illness exclusion from childcare was developed for parents and staff at a rural childcare center, in conjunction with an educational session with the childcare director and staff and provision of full current guidelines.
Increasing Education Surrounding Proper use of Hormone Therapy for Menopausal Patients

Abigail M. Mercier
Short-term Project
This project intends to offer providers an easy way (via a smart phrase in Epic) to increase education in their menopausal patients about vaginal estrogen cream.
Making Exercise Accessible for All

Katina Messier
Short-term Project
Regular physical exercise is often suggested as an important modifiable factor to lessen the occurrence of conditions that are associated with a sedentary lifestyle such as obesity, diabetes, hypertension, and more. However, there is little education surrounding how to exercise, or how to modify movements to fit individual needs. This project serves to educate the public about the importance of exercise, provide movements for each major muscle group, and include modifications based on individual needs.
Dietary Fiber as a Means of Optimizing Health

Carlos Montejo
Short-term Project
More than 90% of the US population does not meet the recommended dietary fiber intake goal of 25-30g per day. Dietary fiber is an essential component of a well-rounded diet and is associated with reduced risk for cardiovascular disease, obesity, and type 2 diabetes mellitus (T2DM). Further, dietary fiber is linked with a reduced risk for colon cancer and has been found to alleviate constipation. Regionally, in Newport, VT, rates of cardiovascular disease, obesity among youth (grades 9-12), and T2DM were significantly higher when compared to the state average. This project aims to inform the community about the importance of incorporating fiber in their diet. Two individuals were interviewed in the Newport community and described the need for more information regarding dietary fiber. A tri-fold pamphlet was created to highlight the role of fiber in the body, how much fiber should be consumed daily, types of food sources rich in fiber, and price breakdowns of non-traditional fiber sources from local supermarkets. The results of this intervention have not been shown. With social determinants of health in mind, the desired outcome is for members of the community to become more conscientious about their diet and the role of dietary fiber in optimizing health outcomes.
Diabetes Prevention in High-Risk Populations

Petergaye Murray
Short-term Project
The American Diabetes Association estimated that the cost of diabetes care in the US in 2022 was $412.9 billion. With numerous patients being diagnosed with prediabetes, it was observed that these patients were underinformed about the necessary changes in diet and exercise needed to delay or prevent diabetes. Two interviews were conducted with professionals who work with diabetes, a pharmacist who providers nutrition counseling, and a physician who oversees the clinical management of diabetes. With their insights and information from nationally recognized resources such as the CDC and the American Diabetes Association, a mini-guide in preventing diabetes was created to disseminate to high-risk patients (patients with pre-diabetes) in clinical settings.