All aspects of practice encountered by the preceptor should become a part of the student's training. Office practice offers a very practical opportunity for students to learn much about the science and the economics, as well as the art of medicine. The preceptor's office is a valuable laboratory for the teaching of ambulatory medicine. Senior students can be taught how to elicit histories, do exams, reach a tentative diagnosis, prescribe under supervision, methods of advising patients and of referring them to other doctors, details of office practice, such as record keeping, filing, billing of patients and collection methods.
The preceptorship committee emphasize that no preceptor should assume that the preceptee may be used as an assistant and certainly not as a substitute to relieve oneself of one's own obligation as a practicing physician. The preceptor should approve or criticize histories and physicals done by the preceptee and should check and countersign any prescriptions ordered by the preceptee either at the time of writing or subsequently with the local pharmacist whose services may be involved.
It should be noted that the taking of histories and physicals should not be overemphasized. There are no regulations concerning when the preceptor should allow a student to participate in the practice or to what extent. Final responsibility for patient care rests entirely with the preceptor. Experience indicates that after a period of observation, most preceptors encourage preceptees to take histories, make physical examinations, and do necessary laboratory work under supervision.
As proficiency is gained and the respect of the preceptor has been earned, the preceptee may be permitted to do surgical dressings, minor procedures, and to assist at operations and in the delivery of obstetrical patients. Each preceptor must determine when a student is qualified to engage in these aspects of practice under his/her supervision.
Students look to their preceptors as their teachers. Many students have indicated the desirability of a conference between the preceptor and the student several times a week. Conferences of one hour or longer can profitably be devoted to the discussion of diagnosis, methods of therapy, and the management of patients. It is also expected that the preceptor will confer with the preceptee concerning the student's evaluations.
Attendance at medical meetings forms an important part of a practitioner's postgraduate education consistent with demands of office and hospital practice. Students should be encouraged to go to county and district medical society meetings and other meetings with the preceptor.
All students will meet as a group with the Director of the Preceptorship program of the Department of Family Medicine the morning of the first day and the afternoon of the final day of the preceptorship. Notices will be sent to the preceptee's mailboxes.
Preceptees may call the Medical Center's library to obtain current literature on interesting cases. Students will be furnished forms for evaluation of the preceptorship and for certain evaluations of the community.
Each student is required to provide oneself with a stethoscope, percussion hammer, and ophthalmoscope-otoscope set. Necessary reference books should be available in the physician's office or hospital, but the student may find one of the brief handbooks or manuals of medicine of practical assistance.
In various meetings with representative groups of preceptors, it has been generally agreed to underwrite a portion of the financial responsibility of the preceptor training program. The preceptors have agreed to pay the transportation of the student from and Omaha for one trip. Board and room are also to be provided by the preceptor. The preceptor is responsible for providing room and transportation for the student's spouse if accompanying the student and he/she makes prior arrangements with the preceptor.
Assignments of students for preceptorships is the right of the Committee but the student may express a special preference for some one doctor or location. Likewise, the preceptor may express his preference for a particular student. Final assignment, however, rests with the Committee.
The Preceptorship Committee
The University of Nebraska College of Medicine
Revision of 1996.
- Medical Student Education
- Nebraska Area Health Education Centers (AHEC)