Continuity, family involvement, and clinical content in a year-long ambulatory care clerkship

Entries in student logbooks for the Ambulatory Care Clerkship at the Michigan State University College of Human Medicine were tabulated by microcomputer for 38,430 patient encounters in five community campuses in 1985 and 1986, and by hand for 32,182 patient encounters in Grand Rapids from 1983 to 1987. The repeat visit rate recorded toward the end of the clerkship by students in family practice settings was approximately 60% of the rate recorded by students taking the clerkship with internists or pediatricians. Students in family practice and in pediatrics had the same degree of exposure to patient families; however, family exposure in internal medicine and in pediatrics was limited to other family members of the same generation as the patient. Distributions of the kinds of patient problems seen were distinctive by specialty and were stable across 5 years.