For Gainesville family practitioner Daniel Rubin, M.D., his preceptorship during his first year of medical school at UF cemented his desire to pursue a career in primary care.
He spent two weeks shadowing an internal medicine doctor in a small town in the Florida Panhandle and liked the connections the doctor had with his patients and community.
“I got to go through all the experiences he went through in a typical day,” said Rubin, a physician with Family Medicine at Haile Plantation. “And it had a very strong appeal to me.”
Now, the 1998 UF College of Medicine alumnus is a preceptor himself, helping current UF medical students gain valuable clinical experience for the first time.
The UF College of Medicine’s 130 first-year students recently completed the Introduction to Clinical Practice preceptorship, which is designed to expose students to strong physician role models demonstrating the relevance of basic science to the clinical practice of medicine while providing a glimpse into the contemporary practice of medicine in a community setting.
“It’s been relatively eye-opening,” said UF medical student Stephen Pape of his preceptorship with Rubin. “I think it really shows you how important preventive medicine is.”
During their preceptorships, students focus on taking a patient’s history, acquiring physical exam skills and helping with minor procedures.
“This is their first really significant patient contact,” said Robert Hatch, M.D., a professor and director of medical education at the College of Medicine.
UF students are typically assigned to a practice within the 37-county Area Health Education Center area, which stretches from Volusia County to the tip of the Florida Panhandle. Students are randomly assigned numbers through a lottery, and based upon that number they choose their preceptor.
This year, however, 37 students, — the highest number ever – were assigned outside the North Central Florida area, including six students who did preceptorships in other states, said Cynthia Freeman, coordinator of UF’s Area Health Education Center Program. That’s up significantly from 2010, which had 19 students assigned outside the North Central Florida area.
That is due in part to a cut in state funding that helped pay for students’ transportation and housing for North Central Florida preceptorships, said Hatch. So this year, assignments were made that allowed more students to live at home while doing their two-week preceptorships, which fall right before the holidays.
“We have been locating doctors in their hometowns who are willing to give them the training they need,” Hatch said. “The biggest drawback is the exposure to rural settings has dropped way down.”
Choi Hyun-ji, a first-year UF medical student whose parents live in California, had a preceptorship at Kaiser Permanente in California. Two of her peers were also assigned to preceptors in California, while others were assigned to Texas, Virginia and Idaho.
“I get to interact with first-, second- and third-year resident physicians as well as family medicine practicing physicians who are involved in academic medicine,” Choi said.
Gabriela Fernandez headed back home to Miami for her preceptorship with pediatrician Margarita “Lily” Taboas, M.D., a 1999 UF COM grad, at South Florida Pediatric Partners.
Fernandez said working in a bilingual practice allowed her to learn medical terminology in Spanish and caring for children strengthened her diagnostic skills since children often can’t explain what’s wrong with them. Overall, the experience reinforced her desire to be a pediatrician.
“(Dr. Taboas) has seen these kids grow and she has such a great rapport with them—that’s what I want,” Fernandez said.
Not all medical schools offer preceptorships to first-year students, said Hatch, and many that do put students with doctors for a few hours between classes throughout the year. UF’s preceptorship program immerses students for three weeks, including one week of lectures and preparation, then two weeks of clinical experience.
Students begin to learn how to apply the basic anatomy and physiology they studied during the fall to real patients and to have a natural conversation with patients while collecting their medical histories.
“I think a lot of it is gaining that confidence and being comfortable with patients,” said Casey Luckhurst, whose preceptor is David Remmer, M.D., a family practitioner at Family Medicine at Haile Plantation in Gainesville.
Remmer, a 2001 UF COM graduate, said his own preceptorship in the Florida panhandle introduced him to patient care and small town life. The pediatrician he shadowed included him in both his work and home life, inviting him to family dinners and his children’s sporting events.
“They had four kids and I pretty much became their fifth kid,” Remmer said.