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Student Continuity Practice

The student continuity practice (SCP) is a three year primary care continuity curriculum that provides students with a longitudinal immersion and mentoring experience in a community based generalist practice. It gives students the opportunity to develop a conceptual understanding of medicine while developing skills in history taking, physical examination and clinical reasoning. Students are also exposed to personal and professional issues that accompany medical training and practice.

Working in the same physician's office for three years provides students with the opportunity to experience continuity with patients, the office staff and the physician. In the first year of medical school, students begin to integrate material from their basic medical science classes and the problem based learning curricula with what they are observing and experiencing at their practice sites. The focus of the first year is on history taking, physical examination, behavior modification techniques, health promotion and disease prevention. In the second year, there is an emphasis on pathology, and practice focused and complete medical histories and physical examinations. With the help of the preceptors, students begin to understand the clinical correlations involved in certain diseases and learn about differential diagnosis and problem lists.

SCP continues in the third year during clinical rotations, a feature of our curriculum that makes it unique among medical schools. Along with the growing body of knowledge and skills, students are given more independence at their sites. Frequently, they will have their own panel of patients. The continuity with the preceptor and office gives students a great sense of security when compared to the changing venues that students experience in their clerkships and outpatient clinics. SCP as a fourth year elective is an option that approximately one quarter of the class chooses.

The 250 community based faculty who participate in SCP include internists, family medicine practitioners, and pediatricians. The retention rates for preceptors have been very high. From the originally recruited cohort between 1995 and 1997, approximately 42 percent continue to mentor students. A majority are in private practice in the urban and suburban communities within an hour’s commute of the medical school. A significant number of students work at community health centers that provide students the opportunity to work with underserved populations.

SCP provides a unique experience allowing the student to experience first-hand the realities of medicine, from patient care to health promotion and disease prevention. Students also gain an appreciation for the business of medicine, and the personal and professional challenges that physicians face. In addition, patients at the sites have been very amicable, allowing them to practice history-taking and physical exam skills. The school would not be able to have such a successful program without the generous participation of community based faculty, their staff, and their patient populations.