Preceptorship Q&A

Here's what students in the MD Program at the University of Wisconsin School of Medicine and Public Health in Madison say about the fourth-year preceptorship.

• What educational opportunities at your preceptorship site did you get most excited about receiving?
• How did the education received at your preceptorship site compare to what you were most concerned about?
• 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?
• How did your educational opportunities at your preceptorship compare to your education elsewhere?
• How did providing medical care in your preceptorship community compare to the care you have participated in at other locations?
• What did you enjoy most?
• Would you like to live in your preceptorship community as a practicing physician? If so, why?

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

A: The most interesting activities were talking with health care personnel who weren't always directly dealing with clinical care — hospital CEO, chaplain, public health nurse, psych services, jail medicine, chiropractors, etc.

A: I had been looking forward to working with the Amish population, and while I did see a few Amish patients, I saw just as many eastern European immigrants with limited English proficiency who were working in the area. It was interesting to see the patients beforehand, and then seeing how the doctor I working with functioned in that setting.

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: I wasn't concerned about any issues going into my preceptorship, but I was satisfied to learn how competent the family physicians were at taking care of patients in the outpatient setting and inpatient setting. They were very prudent at knowing what they could handle in the hospital and what needed to be sent to the larger hospital center. They were absolutely fabulous mentors!

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: No, the community exceeded my expectations. The patient population was very kind toward me and graciously allowed me to interview and examine patients independently of my physician preceptors. The clinic staff were all very kind and welcoming, despite our political differences during the presidential elections. I was stunned by the beauty of the city. There was a nicely groomed park and lake in the middle of Watertown filled with a large community of ducks who cross Division Street every morning at 7:30am. The duck migration stops traffic and mesmerized me as this was an example of nature taking advantage of pedestrian rules.

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: I got way more hands-on experience since residents weren't around. I got to deliver babies on my own without a bunch of other hands there and I got to be first assist on C-sections that occurred at night. I got to place IUDs. All of these things would not have occurred in Madison.

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 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: All the people. All the hospital staff was very welcoming. I worked with great physicians who let me take on a lot of responsibility and perform a lot of procedures (two tonsillectomies, and a hydrocelectomy/orchiectomy from start to finish by myself, while under close supervision of course.) I also got to meet a lot of fantastic patients.

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 followup 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: I like the diversity of things I got to see. I spent a week with dermatologist, I spent a week with family practice residents, I spent several weeks with family practice docs and a few days with traveling nurses. The patient population problems they faced were very diverse.

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: Yes, as a GP I would like the group care arrangement that Black River employs. I also think the size of this community would be a great fit for me, and I'm glad I was able to have a rotation there.

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.