Jane Phillips, MD, a San Francisco pediatrician in private practice until 2002, began her career as a preceptor with her first student in the 1980s. The student became a radiation oncologist, and also a mother, who chose Phillips to be her child’s pediatrician. In turn, Phillips for years consulted with her former student for information about cancer.

This lifelong relationship, evolving from teacher-student to colleagues, attests to the power of preceptorships, often the first one-on-one relationship a student will have with a teaching physician.

This early exposure can have an “imprinting” effect, according to Phillips. It may influence a choice of specialty, as was the case for another one of Phillips’ students who eventually decided to become a pediatrician, though he had been leaning towards internal medicine before working with Phillips.

Preceptorships provide students early exposure to clinical care to develop a more realistic understanding of applying what they learn in the classroom to patient care. As much as possible, preceptorships are designed to align with the curriculum under concurrent study.

Starting in the first year, for up to two afternoons each month, UCSF medical students travel to office-based practices across the Bay Area, from Santa Rosa to Pleasanton to the peninsula, to be under the tutelage of a teaching physician. Students start out observing and gradually become more engaged in practicing such skills as interviewing patients, taking a medical history, and performing physical examinations.

“Patients and parents like it when I have a student with me,” says Howard Chow, MD, a pediatrician in San Mateo who has served as a preceptor for three years since completing his residency at UCSF, “because I tend to explain more about what I’m doing - why I think the patient may have an ear infection, for example.”

A labor of love

With the increasing demands of private practice, it is quite a commitment to take on teaching duties as well, which makes it all the more impressive that 65 percent of those who serve as UCSF preceptors are volunteers.

“It’s a labor of love,” says program coordinator Cynthia Irvine, “as well as an enormous contribution to shaping the next generation of physicians.”

“One of the most rewarding things I did when I went to UCSF was working with doctors in community practices,” says family physician Roger Pitzen, MD, who has worked with medical students for 23 years in his four-physician practice in Sebastopol. Recently recognized with UCSF’s prestigious Kaiser Award for Excellence in Teaching, Pitzen says precepting offers a way to “give something back” to medical students.

Early exposure to clinical care follows a national trend. In the mid-1990s, UCSF was one of 10 demonstration schools in a national project designed to build ambulatory care into the first two years of medical school, funded by the Health Resources and Services Administration. By 1996, preceptorships had been integrated as a required part of the curriculum.

“Although there have been many obstacles to implementing these early preceptorship experiences,” says William Shore, MD, director of medical student education programs in the Department of Family and Community Medicine, “students have found them to be very helpful in their learning process and their development as physicians.”