10+ Year Member
Oct 29, 2006
Attending Physician
Over the next few months I've got to make the decision on what to do about 3rd & 4th year rotations. Most of my options are at teaching hospitals, and some pretty good ones, but for other reasons independent of education I may elect to choose a preceptor-based site.

Obviously not having been on rotations I can't completely say I'd end up in psychiatry, but I have some experience with the field and it's been my biggest interest from the get-go. With this in mind, I'm interested in taking advantage of years 3-4 not to develop my interest in psychiatry, but rather to gain suitable skills that will make me a competent physician in order that I may be a better psychiatrist.

So my question is, in general, in the long run would there really be any appreciable difference between opting for preceptor-based over hospital-based rotations w/regard to psychiatry? My issues for and against are as follows:

1. Generally people believe preceptor-based is inferior educationally, and to a certain extent I agree, but to another I see its potential positives (though not as many). The most commonly cited pro for preceptor is that you are able to do more rather than being behind the resident and intern as far as doing procedures, etc.

2. I feel being with a specific preceptor may not be a representative idea of the practice in that particular field, while hospital-based would likely be more generalized. In some regards I could see this as a good thing, however, as for instance on OB you will still be seeing deliveries, you will also be getting a lot of outpatient OB and get more familiar with a lot of OB issues that will be more relevant to psych practice than being in the delivery room.

3. I visited the rotation site I'm contemplating during their didactics and it seemed pretty laid back as far as rotations go. I'm mixed about this. Thus far in school I've made my family my first priority (and always will) so this makes things easier in that sense, but on the other hand I just feel I would need the reassurance that should I do my part that a preceptor site would fit me educationally. I don't particularly think being on call as a medical student would be all that beneficial, but obviously I have no basis for that opinion.

As most of you have done years 3-4 and many are in residency or practice, what things would you recommend I give consideration to that may typically overlooked by my more limited experience?