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SUMMARY RECOMMENDATIONS |
Comments For Those Preparing Rural Physicians |
| Overall - | |
| 1.The goals of clinical education should focus on the mastery of a core set of skills as well as on the acquisition of factual content. | Generalism provides the skill set that would satisfy this requirement. |
| 2. Assessment of a student’s performance, particularly for mastery of the core skills, is a critical component of the educational process and must be conducted at critical points. | Working with a preceptor over several months is a regular form of evaluation that can be more detailed and thorough than any current form, even identifying impaired or deceptive students, the most difficult task of medical education and the most expensive for society. |
| 3. Topics that are not specific to a particular clinical discipline (sometimes called “orphan topics”) need to be integrated more effectively into the curriculum. | Primary care physicians have to deal with "orphan topics" every day. Having a larger volume and a broader scope of practice such as in rural areas helps. |
4. Greater integration is necessary across the curriculum, e.g., between basic science and clinical medicine, and across different specialty disciplines. |
Long term preceptorships allow an integration and centralization that is not possible in traditional medical centers. |
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5. The organization and oversight of the curriculum should be centralized within the medical school rather than distributed to individual departments. |
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6. The educational experience needs to be centered more around the patient than around the inpatient team. |
Where did we leave the patient behind and why? The priority for learning to be a physician is learners being responsible for patients, getting involved, and making decisions, with close supervision by teachers. |
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7. Better use needs to be made of the fourth year of medical school, and innovative educational programs need to be developed that link the fourth year to the overall educational goals of medical education. |
Why not use the fourth year for better career preparation |
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8. Transition periods in the curriculum, e.g., from preclinical to clinical experiences, from medical school to housestaff training, are important opportunities and priorities for educational innovation and reform. |
These transitions are critical points for the development of a rural primary care physician. Mercer bridges the preclinical to clinical with a 2 month rural primary care rotation, Nebraska bridges the medical school to graduate transition with the accelerated rural training program, and the transition to practice can be enhanced by rural rotations and moonlighting. |
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9. Development of a “core faculty” of medical educators is an important step toward addressing the problems facing clinical education in a period of increasing pressures on clinical productivity. |
Working with rural preceptors and adding coordinators can further enhance clinical productivity as well as improve the quality of teaching. |
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10. Better tools need to be developed to evaluate faculty as teachers, with the corollary that excellent teaching should be rewarded appropriately |
Absolutely! |
Millennium Conference on the Clinical Education of Medical Students