The longitudinal primary care clerkship at Harvard Medical School

The primary care clerkship (PCC) at Harvard medical School was established in 1997, The goals are to provide students with longitudinal experiences wi th patients and to include modem themes in the curriculum: managing illness and clinical relationships over time; finding the best available answers t o clinical questions; preventing illness and promoting health; dealing with clinical uncertainty; getting the best outcomes with available resources; working in a health care team; and sharing decision making with patients. T he PCC, a required course in the clinical years, meets one afternoon a week for nine months, Students spend three afternoons per month in primary care practices, where they see three to five patients per session and follow at least one patient ("longitudinal patient") over time. Classroom sessions, in both large- and small-group formats, promote a common educational philos ophy and experience, and reinforce habits of problem-based learning establi shed in the preclinical years, The students rated 74% of their preceptors e xcellent, especially praising their ability to facilitate and support good interpersonal relationships with patients, their ability to encourage stude nts' independent evaluation of patients (as opposed to shadowing) and their enthusiasm for teaching, Students san their longitudinal patients a mean o f 4.8 times; 83% saw their patients at least three times, The PCC complemen ts the curriculum of block clerkships in hospitals, and because the two are offered concurrently, students are required to come to terms with two subs tantially different cultures within medicine, Other medical schools are beg inning to develop longitudinal clerkships to ensure that students have esse ntial educational experiences that are difficult to achieve in block, hospi tal-based clerkships.