Would be nice if I posted what I said I'd post
I apologize in advance for the length of this post. Hopefully this will answer some of your questions, as I have answered this many times on various threads.
I think preceptorship has its place and here are the rotations where I think students will benefit the most from a preceptorship rotation:
1. family practice (office based is where most if not all of the practitioners are now, so students should be exposed to this environment).
2. pediatrics: most kids are well or have minor illnesses that are treatable in office. There should be some exposure to inpatient but the bulk is out patient.
2. psychiatry: it can go either way, but this is a good place to start (out patient)
3. gynecology: well women visits, etc.
Inpatient rotations: these medical fields I believe personally need to have a predominant focus in the hospital (don't get me wrong, there needs to be some outpatient focus as well, but in a minor way)
1. Surgery
2. Obstetrics (with a clinic component)
3. Internal medicine
I just stated my preferences. Remember there are pros and cons to both models. I was lucky enough to get excellent preceptors (all 10 of my core rotations were preceptorship based, but I went with my attendings to round on patients in the hospital and I wrote notes on the charts etc, I had NO RESIDENTS TO ANSWER TO OR HOLD ME BACK) but there are some bad preceptors too. Just as if you went to a teaching hospital, not all residents know what they are doing or how to teach. Your interaction with the attendings in some teaching hospitals can be almost non existent.
Now for the facts of preceptorship at AZCOM. Since there is a shortage (and this is well documented) of docs in the Valley and from my personal experience with preceptors in the Valley, there is no dearth of patients for the docs so you will have lots of patients to see (many offices are very high volume and it takes forever, say the patients, to get an appointment).
If you are still concerned about being in a preceptorship experience, 5 out of 11 of your core third year rotations and all of your fourth year can be taken out of state, so you may be able to get as many inpatient rotations as you desire. The hospitals in the Valley that are U of A affiliates, have been easing their restrictions on our students and AZCOM students (mainly 4th years) have been taking advantage of this. When I did my fourth year SICU rotation at Maricopa, I saw at least a quarter of my classmates doing other rotations there. I personally know at least 4 of my classmates that are PGY-1's there and it was their first choice. Getting third year core rotations at the major teaching hospitals (in the Valley) are still hard, but things may change by the time you are a third year (in addition to U of A, Kirksville and Western U in Pomona had already established rotations there before AZCOM came into existence).
Planning your clinical years can be overwhelming. My suggestion to you is to do the following early: Find one or more reliable students in the class before you (your big sis/bro and perhaps their big sis/bro, with similar work ethic, goals as you) and ask for advice (best hospitals, best preceptors, most teaching, best opportunities). The third year coordinator, Linda is awesome. If you ask her for advice or tell her what your goals are, she usually is able to steer you in the right direction.
I am very happy with my education, I would not trade it in for the world. I mentioned that I was rotating through OB right now and I am watching the medical students (and there are quite a few here now) vying for just one vaginal delivery. I had done at least 11 (7 unassisted) in a rural rotation where I was the ONLY student with an attending (NO RESIDENTS TO CONTEND WITH EITHER)
Did I do H&P's: Up the wazoo!!!
Pimped: Heck yeah!!! (but then again, all of my preceptors were into teaching, I have heard some of my colleagues had preceptors that were not)
Am I and was I prepared, hands down YES!!!
I hope this info is helpful, it may be confusing as you are not in the thick of it yet, but you will see more growth and improvement as the school has a stronger foothold in AZ. Don't worry about your education should you decide to go to AZCOM, my class personally, has made it to some of the best residency programs (in PHX as well as the rest of the country) and most got their first or second choice slots (go to
www.azstudents.org and click on the link to Class of 2002 residency match). My best to you
PS I did my third year IM with an awesome hospitalist group in the Valley, if you can not get an inpatient IM, I strongly suggest going with a hospitalist group somewhere. Don't do an office based IM practice. I got a 4th year sub-i in IM at Mayo in Scottsdale and I was more than prepared.
ted, D.O.
Emergency Medicine PGY-1