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Ambulatory Acting Internship Q&A

Here's what students in the Legacy MD Program at the University of Wisconsin School of Medicine and Public Health in Madison say about the Ambulatory Acting Internship.

Q: What educational opportunities at your preceptorship site did you get most excited about receiving?


A: Seeing every patient independently in clinic. Worked a significant amount of time with addiction specialists.  Having the opportunity and expectation to interact with a variety of health professionals (e.g., public health nurse, performance improvement director, CEO of hospital, etc.). Independent study on QI through the Institute of Healthcare Improvement.


A: Just discussing each patient with my preceptor or another provider and jointly drawing conclusions/making plans with patients. It was also exciting to learn and practice some office and ER procedures - suturing, liquid nitrogen treatments, biopsies, vasectomy, IUD placement, suprapubic catheter changes, cautery for nose bleeds, incision and drainage, etc.


A: Spending a day at the nearby Native American reservation was most instructive. I learned about the Indian Health System finance mechanism, the type of chronic medical issues the population deals with, and the evolution of the local clinic. I enjoyed seeing something so different from anything I had seen before.


Q: How did the education received at your preceptorship site compare to what you were most concerned about?


A: While my preceptors did a bit less pure didactic teaching, they did spend a lot of time talking with me about their thoughts and approaches to medicine and life. Instead of learning the details of how to treat someone with lupis, I learned more about what types of things are important to look for in a career, how to work with difficult patients and how to make a bigger benefit in patient's lives.


A: I wanted to have the opportunity to further develop my physical exam skills and ability to develop a good differential and plan for the patients. I was able to begin doing this more about halfway through the rotation as I was comfortable with the format and had seen enough different pathology to start being more independent in this function.


A: I actually think it was better than what I expected. Again, my preceptor is very knowledgeable and did a lot of teaching. Working with him one-on-one allowed him to observe very closely what I can do and subsequently he gave me more and more responsibility as the weeks went on. Also, there are several subspecialists that I spent time with during the rotation that provided some great learning opportunities.


Q: Did your expectations about your preceptorship community (i.e., social activities, culture, shopping, recreational activities, etc.) match your experience there? If not, how did they differ?


A: In some ways the social activities, culture and shopping exceeded my expectations. Viroqua Public Market, Art Vision, Organic Food Co-op.


A: I didn't really have too many expectations. My preceptor was a great help in telling me about a park with a lake for me to walk around and enjoy the beautiful weather. He also told me about a great place with Norwegian chocolate. It also turned out that there was a great café in town - local, organic and changing menu, it was fabulous!


A: No. Even better - weekly summer outdoor concerts, many parades, a number of shows, more hiking trails than previously thought ...


Q: How did your educational opportunities at your preceptorship compare to your education elsewhere?


A: Much better. One-on-one interactions with EM, ENT, ortho, IM, dermatology, anesthesia, surgery and OB made learning easier. My clinical skills improved. I learned more in one week of listening to hearts with someone who was willing to listen after I did and to discuss what we heard ... or looking in ears.


A: In terms of breadth, this rotation could not be beat. I would use the analogy of a "medical playground," complete with monkey bars (i.e., subspecialty centers), slides (i.e., surgical suites), basketball hoops (i.e., emergency room medicine) and swings (i.e., primary care clinics). Much of the education was independently sought out, but I learned more on this rotation than I have on most of my other rotations.


A: I felt that the educational opportunities during my preceptorship were outstanding. I have never seen as much advanced pathology (i.e., women with no prior mammography presenting to clinic with breast tumors greater than 5 or 6 cm and positive lymph nodes) as I'd seen during my time there. Also, my preceptor liked to discuss current issues in health care and in medical student/resident education. He was a great mentor and teacher.


Q: How did providing medical care in your preceptorship community compare to the care you have participated in at other locations?


A: The care provided was excellent. The practitioners were deeply invested in the care of patients. Practitioners were very knowledgeable and skilled. I thought it was interesting that some practitioners were trained to do C-sections that would be reserved for obstetricians in a more urban environment. The general surgeons were also competent in procedures that would be done by specialists in other locations.


A: In some ways it has surpassed care in other locations. The physicians here are very versatile and advocate strongly for their patients. We went on house calls for people (Amish) who could not make it to the hospital or clinic, which was a great and unique experience.


A: It was much more personal and continual. From one preceptor to another, I saw a lot of the same patients. There was much more of a long-term relationship evident between patients and health care workers. They knew each other not just from the clinic setting, but also from church or other community activities. 


Q: What did you enjoy most?


A: I enjoyed taking care of warm-hearted, respectful and hospitable patients. The patients exemplified the stereotypical friendly Midwesterner. Not only did they respect the role of the medical student more than anywhere else, but they took a genuine interest in me as a person. I really felt like the physician/patient relationship was a two-way street and I felt more connected to them than I had anywhere else.


A: Continuity of care. Evaluating the patient for surgical disease, taking them to the OR and participating in the case, following them in the hospital post-operatively, and then seeing them in follow up as an outpatient. Prior to this experience, I had never seen a single patient through all of those stages of surgical care. I also enjoyed working one-on-one with my preceptor and having the opportunity to be first-assist in the OR. No residents!


A: The ability to pursue opportunities in interest to me, ranging from interdisciplinary breast cancer conferences and clinics to working with a family physician who serves a self-pay mostly Mennonite practice.


Q: Would you like to live in your preceptorship community as a practicing physician? If so, why?


A: I would love to live in the community. This community is very close-knit; in clinic, I would see individuals from the community, including individuals that owned the local grocery store, as well as individuals from the hospital.


A: Definitely. Family medicine practitioners were the only primary care physicians in the county and saw a large scope of patients. Everyone worked hard to provide care and had great attitudes. This felt like a "home" community to me.


A: Someday. This would be a fantastic community in which to raise a family. I would like to practice in a larger community for a few years, but would eventually like to practice in a less urban environment.

Ambulatory Acting Internship Q&A

Last updated: 04/14/2017
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