Early ambulatory experience in the undergraduate education of family physicians

A number of benefits have been claimed for early ambulatory experience in the training of family physicians, although few practical examples have been reported. This paper describes an approach to the education of first and second year medical students interested in family medicine which places heavy emphasis on community-based ambulatory care. During the first year, an elective introductory preceptorship permits students to participate in the office practice of a family physician in a limited role. Seminars are offered concurrently to provide integrating principles and perspective. In the second year, a nine-month-long continuity clerkship is offered in which students gain intimate contact with a small panel of families and practice the skills of primary care in the offices of family physicians. Clinical experience is accompanied by weekly seminars and integrated with elements of the required curriculum. Selected evaluation data are presented, which attest to the achievement of course objectives and provide support for the claim that this approach is beneficial to students seeking careers in primary care.