PCC Student Guide
Table of Contents
- Introduction
- PCC Educational Goals
- PCC Learning Objectives
- The Clinical Experience
- Problem Based Learning and Doctor Patient Communication Sessions
- Suggested Electronic Resources
- PDAs and Audio Recorders
- PCC Attendance Policy
- Transportation
- Professionalism
- PCC Requirements
- PCC Final Exam
- Evaluation and Grading
- PCC Course Administration
- Frequently Asked Questions
1 - Introduction
Welcome to the Primary Care: Family Medicine, General Medicine, Pediatrics Clerkship (PCC). During this eight-week rotation, you will have the opportunity to experience the variety of patient encounters found in primary care. While most of the clinical rotations in the third year occur in the hospital setting, the PCC is situated in the community where most primary health care is delivered.
The field of primary care is vast and this clerkship is meant to serve only as an introduction. On behalf of our faculty, staff and community preceptors throughout the state, we welcome your participation in the PCC. Enjoy your experience as a member of a primary health care team.
John Brill, MD
Course Director
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2 - Primary Care Clerkship Educational Goals
By the completion of this clerkship the student is expected to possess the knowledge, attitudes and skills to:
- Describe the nature and scope of primary care practice and how it interacts with other health professions.
- Assess and manage common acute and chronic ambulatory medical problems.
- Determine the health risks of patients and populations and make recommendations for screening and health promotion.
- Identify community resources available to enhance patient care as well as barriers to optimal care.
- Establish effective relationships with patients and families using patient-centered communication skills.
- Practice life-long learning skills, including the application of scientific evidence in clinical care.
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3 - Primary Care Clerkship Learning Objectives
The Learning Objectives constitute the curriculum for the clerkship for which you may be tested. Collectively they are the most frequent issues encountered in primary care practice.
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4 - The PCC Clinical Experience
Each student works with community-based family physicians, general internists or pediatricians. These physicians volunteer their time to provide students exposure to primary care. Students are expected to take advantage of the many learning opportunities available during the rotation. Student-patient encounters frequently afford independent learning opportunities for the student to explore in depth when not in clinic. Students will also discuss selected topics in depth in small group problem based learning sessions.
In addition to learning from patient issues encountered during the clinical sessions, students are encouraged to take time to note the importance of the physician-patient relationship, to assess the health problems and resources of the community in which they practice, and to participate in the coordination of health care.
Generally, students are scheduled to work in two clinics, one family medicine and one internal medicine or pediatrics; you will be at each 3-4 half days a week. Most clinics serve a broad spectrum of patient needs. Some clinicians may have areas of particular interest that serve a more specialized group of patients. Be sure to take advantage of both of these opportunities. The level of student independence may vary from clinic to clinic. Current Medicare guidelines restrict student documentation to the following: students may enter a patient's past, family, social history and review of systems; in some locations, students may be allowed to dictate, noting that they are "dictating as a scribe for Dr. ____." Each of our partnering institutions interprets Medicare guidelines slightly differently, so expect some variability. You are encouraged to get permission from your preceptor to enter background information and write orders and prescriptions in either paper or electronic records.
Your clinical experience should be a mix of shadowing, observing clinical encounters as well as independent activities. Preceptors often have their student shadow at the beginning of the rotation to determine the student's level of clinical expertise. Your level of independence should increase as the preceptor becomes more familiar with the your strengths and weaknesses. PCC preceptors are encouraged to observe their student performing all aspects of patient care: history acquisition, physical examination, care plan development and discussion of the plan with the patient. All students should have both supervised and independent patient interactions throughout the rotation. Students are also strongly encouraged to assist your preceptor and office staff in clinical procedures
Helpful Hints When Working in a Clinic
1. Get to know the clinic staff. Interactions with the clinic staff will allow a better understanding of the demands of ambulatory medicine.
2. It is not necessary for you to see every patient. Try to see every second or third patient and spend time between patients looking up clinical care information to discuss with the preceptor. This can be a useful strategy if you are working with a very busy clinician who has limited time for discussions between patients.
3. Arrange to see patient conditions that meet your educational needs. If you feel the need for additional exposure to a particular type of patient or medical condition, be sure to discuss this with your preceptors as they may be able to make accommodations to meet your specific needs. If, however, your preceptor is not able to accommodate your request and you feel your clinical experience is being significantly compromised, contact your regional coordinator or Claire Ann Boyce early in the rotation to allow time to make any needed changes.
4. Access point of care information. Remember that most of your preceptors finished their training before electronic databases even existed. Although the use of practice guidelines and electronic resources for making treatment decisions is a major emphasis of the PCC educational objectives, you may not see this approach modeled in your clinical settings. This should not discourage your use of these resources. The value of point-of-care information to improve diagnostic and treatment decisions has been validated, and there is general agreement the use of point-of-care resources will become a significant part of future clinical practice.
5. Respect differences in patient care decisions. Occasionally you may observe patient care decisions that seem to be in conflict with the information you discover when completing your learning objectives. If done tactfully, these can be significant opportunities for learning with your preceptor. If, for example, you see a patient whose cholesterol is higher than would seem appropriate based upon your understanding of the current guidelines, it would be better to ask a general question such as "Dr. X, could you explain to me how you use the NCEP guidelines in cholesterol management?" and not "Doctor X, according to what I read you should be treating Mrs. Smith's cholesterol more aggressively." Please remember that you are a guest in your preceptor's office and that such discussions are probably best to have away from the patient.
6. Be prepared to take advantage of valuable learning opportunities. Preceptors may require students to accompany them on hospital visits, home visits or evening call. Students are expected to take advantage of these valuable learning opportunities. Contact your site coordinator if your preceptor reduces your schedule to less than three half-days a week.
7. Bring your stethoscope. The only equipment you are likely to need is your stethoscope.
Tracking Core Clinical Experiences.
The UWSMPH has asked each third year clerkship to identify up to 10 core conditions and ask that students track what experiences they have in regard to these conditions.
From the list of PCC learning topics, we identified 10 primary care core conditions for you to track on OASIS
1. Hypertension
2. Diabetes Type 2
3. Depression
4. Asthma/Chronic lung disease
5. Chest pain
6. Headache
7. Abdominal Pain
8. Acute respiratory infection
9. Well Child Check
10. Adult physical or Wellness visit
Note: There are several learning topics which are not among the core conditions you will be tracking, such as back pain and urinary/vaginal symptoms. By the end of the rotation you will required to be competent in (and may be tested on) all PCC Learning Objectives.
How to Elicit Feedback From Your Preceptor
Preceptors have different approaches to teaching and providing feedback to students. Most preceptors have busy clinical practices and must adapt their teaching styles to meet the time constraints of their practice. Here are ways in which you can elicite feedback from a busy physician.
1. Ask. Start by asking your preceptor how he/she would like to provide you with feedback (between patients, with patient, at the end of the day). When convient, ask you preceptor how you are doing. Asking specific questions such as "Would you like for me to do something different in my presentations" will more likely to elicit constructive feedbackthan a more general 'How am I doing?'
2. Prepare an Individual Learning Plan at orientation, you will be required to complete an Individual Learning Plan. During the first week, review your Individual Learning Plan with each of your primary preceptors. Throughout the rotation, use this form when asking for feedback on your progress in meeting your goals.
3. Review your Mid Rotation Feedback form with your preceptors. Toward the end of the third week of the rotation ask each of your primary preceptors to suggest a time when you could sit down to go over your Mid Rotation feedback form. Turn your completed forms into your regional site coordinator, preferably by the end of Week 4 but no later than the end of Week 5. OASIS will send you a reminder email to complete and turn in this form.
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5 - Problem Based Learning and Dr/Pt Communication Sessions
One morning or afternoon a week, PCC students at your site come together discuss a series of problem-based learning (PBL) cases. In this learning format, students are expected to develop a differential diagnosis, decide what further tests are needed and determine a patient care plan. Each case should generate a set of learning points that require further investigation. Students will present the answers to the learning topic they choose to investigate to the group the during the next PBL session. What is unique about learning in the PBL format is that the sessions are student-directed and driven. A faculty moderator is present to provide minimal guidance and direction to the group.
There are five PBL cases. It is important that all of the cases are discussed during these sessions. The cases build upon the learning objectives and will help you master the objectives. Students are expected to discuss the same patient scenarios regardless of the location of their clinical experience.
Each week, we will email your clinical preceptors to inform them of the PBL case you will be discussing that week. Ask your preceptors if they expect to see a patient with a problem similar to your PBL case. Arrange to spend some time with your preceptor to discuss these patients.
EBM Write-Ups for Problem-Based Learning (PBL) cases.
In order to enhance student experience in Evidence-Based Medicine, your student group and small group leader should designate at least one report per case to address a clinical question in the PICO (Patient/Intervention/Comparison/Outcome) format. Here are several questions written in the PICO format: PICO Write-up Examples (pdf)
You have experience in this process from your M2 Patient-Doctor-Society course. You can review this curriculum if you need a refresher at http://www.med.wisc.edu/pds/index.php
This responsibility should be rotated among the students in your small group so that each student completes at least one write-up in the PICO format.
Portfolio Submissions
A new requirement of the medical school is that each student develop a portfolio, demonstrating their proficiency in the ACGME core competencies. Each clerkship will be choosing representative student work to include in the portfolios.
For the Primary Care Clerkship, we require each student to select and submit two of their reports from the Problem-Based Learning cases. The EBM / PICO write-ups would be excellent examples to include, but this is not mandatory.
Depending upon the topic, your interests, and your small group leader instructions, your reports may be in the form of a presentation (e.g. PowerPoint), written document, or other format. Any mode that can be electronically submitted is acceptable.
These submissions are not graded (beyond being generally part of your small group leader’s evaluation).
Some examples of previous student write-ups can be reviewed here:
- PBL Sample: Lactose intolerance
- PBL Sample: Medications for Smoking Cessation
- PBL Sample: Pain Management in the Elderly
PCC Cases & Questions Forum:
In addition to the weekly PBL sessions, students can review additional cases and discussion questions. These cases and questions were developed to provide a format for the student group to reflect on and prepare for the written exam and OSCE. Students are invited to post their thoughts, online resources they have discovered, advice from preceptors, and any other helpful information.
Doctor-Patient Communication Curriculum
Students at each site come together for three, 90-minute, structured Doctor/Patient Communication sessions. These sessions are designed to develop competencies related to communication issues commonly encountered in most patient care settings. The Doctor-Patient Communication curriculum builds on the activities of PDS. You should expect the following patient scenarios to be presented:
- An angry patient
- A non-compliant patient
- A patient with multiple medical problems
- Breaking bad news to a patient
Each student in your group will be asked to video tape patient encounters for review during these sessions. You are required to obtain patient consent from each videotaped patient. The purpose of the taping session is to evaluate your communications skills, not your medical knowledge. Patients with straightforward problems are usually the most appropriate type of patient to tape. Your preceptor will be sent an email reminder of your need to videotape a patient interview. Don't hesitate to ask your preceptor for help in selecting a patient to tape. The PCC videotape is designed to build upon previous videotape experience in PDS, ideally by going beyond obtaining a patient history to demonstrating how you discuss a diagnosis and management plan with a patient.
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6 - Suggested Electronic Resources
- Agency for Healthcare Research & Quality
Includes US Preventive Services Task Force recommendations and rationale; patient education materials, research & database resources, information on vulnerable populations
http://www.ahrq.gov/
http://epss.ahrq.gov/PDA/index.jsp (Download PDA version of the US Preventive Services Task Force recommendations for screening and access a web-based screening recommendations summary: e.g. enter patient age/gender, see what's recommended) - American Academy of Family Physicians (AAFP)
http://www.aafp.org/ - American Academy of Pediatrics
http://www.aap.org/ - Association of American Medical Colleges (AAMC)
http://www.aamc.org/ - BMJ: British Medical Journal
http://www.bmj.com/ - Center for Disease Control and Prevention (CDC)
http://www.cdc.gov/ - The Cochrane Library
Widely quoted EBM resource.
http://www.cochrane.org/ - CRIT - Clinical References on the Intranet
Maintained by UW Health Sciences Library and UW Health, this web site contains many links to clinical references.
http://www.hosp.wisc.edu/crit/ - Family Medicine Digital Resource Library, A service of the Society of
Teachers of Family Medicine
http://www.fmdrl.org/ - National Guideline Clearinghouse
The National Guidelines Clearinghouse (NGC) is an Internet Web site intended to make evidence-based clinical practice guidelines and related abstract, summary, and comparison materials widely available to health care professionals.
http://www.guideline.gov/ - Patient-Oriented Evidence that Matters (POEMs)
This is part of Essential Evidence Plus which is accessed through the Ebling Library Webpage. Each month, the editors of the Journal of Family Practice carefully review over 80 peer-reviewed medical journals. They apply the "POEMs" criteria to identify the most important articles for primary care physicians.
http://www.infopoems.com/index.htm - UW-Madison Health Sciences Library
Including access to OVID, Medline and other databases.
http://www.hsl.wisc.edu - Virtual Hospital - University of Iowa
Digital health sciences library containing hundreds of books and brochures for health care providers and patients.
http://www.vh.org/Providers/Providers.html/ - Welch Medical Library of Johns Hopkins University
An excellent portal for EBM resources, PDA programs and resources, tools and tutorials
http://www.welch.jhu.edu/internet/ebr.html - Wisconsin Academy of Family Physicians (WAFP)
http://www.wafp.org/
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7 - PDAs, Personal Computers, Recorders
Plan to use your personal computer and PDA during the clerkship. You be provided with a video recorder and tapes for Doctor-Patient Communication. Recorders distributed at orientation must be returned to the Madison end of rotation feedback session.
Students must pay for any lost or damaged recorders to receive their final grade.
Students are provided with a list of recommended PDA-based resources. These resources will enhance the student's ability to access point of care information during their clinical experience. Students are encouraged to download a copy of Essential Evidence Plus into a PDA. Essential Evidence Plus has many useful components including EBM databases, clinical guidelines, clinical calculators and health maintenance recommendations. Essential Evidence Plus requires a PDA at least as fast as a Palm Tungsten e. The use of a slower PDA results in very long loading times as well as long waits to retrieve information. A memory card is also required to download the program.
Direct questions regarding how to download programs may be directed to Nate Gullick Although some students initially find Essential Evidence Plus difficult to navigate, continued use usually results in a rapid learning curve and ease of navigation.
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8 - PCC Attendance Policy
You are required to attend all scheduled clinical and curriculum sessions, and participate in after-hours call, nursing home visits, home visits, hospital rounds or other community health activities if requested by a preceptor. If special circumstances prevent you from participating in these activities:
1. Discuss the circumstances with your preceptor. Some preceptors may ask students to attend early evening and/or Saturday morning clinic.
2. Notifying your regional site coordinator or Claire Ann Boyce
A student missing more than 10% of any scheduled clerkship activity will be required to make up the deficiency. Check with your small group leader or site coordinator about how to make up missed time so that it does not affect your grade.
The PCC follows the medical school policy regarding excused absences. No more than three excused absences are allowed during a clinical rotation. If you have more than three absences you may be required to repeat the rotation. Absences must be approved by the PCC Clerkship Director, or, in his absence, the site coordinator or Claire Ann Boyce. Although clinical preceptors should be notified of any absences, approval for the time away must be obtained prior to the absence from the regional coordinator or the PCC office. Any absences that are not approved by the regional coordinator or the PCC office will likely result in a failing grade for the rotation.
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9 - Transportation
Students are required to have transportation during this rotation because clinic assignments may be up to an hour away.
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10 - Professionalism
Students are expected to maintain the highest standards of professionalism during the Primary Care Clerkship. It is a privilege to be invited into the practice of community physicians. You are an ambassador of the UW School of Medicine and Public Health. We rely on you to respect teachers, preceptors and patients and to display ethical behavior. Your clinical site will determine acceptable attire. Students are expected to adhere to these expectations. At some sites, you are housed in shared homes, apartments or call rooms. The use of good judgment is critical to your professional reputation. Check with your site coordinator for further details if you have any questions about professional expectations.
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11 - PCC Requirements
1. Attend Madison Orientation and, if applicable, the regional site orientation
2. Report to clinics, Problem Based Learning and Dr/Pt Communication sessions as scheduled and on time. Adhere to the PCC Attendance Policy (See Section 10)
3. Regularly elicit feedback from your clinical preceptors on your performance.
4. Track PCC Core clinical experiences on OASIS
5. As instructed by your Dr/Pt communication instructor, tape a patient encounter and bring the video tape to class.
6. As designated by your small group leader and group, complete at least one report to address a clinical question in the PICO (Patient/Intervention/Control/Outcome) format.
7. By the end of the clerkship, be able to demonstrate competency of the PCC Learning Objectives.
8. Complete the PCC final online exam and OSCE exam as scheduled.
9. Contact PCC Administrative staff as early as possible with problems
10. Review your Mid Rotation Feedback form with each primary preceptor. Return form to Regional Site Coordinator no later than the end of Week 5 (preferably by the end of Week 4). You will receive an email from the medical school reminding you to accomplish this requirement.
11. Complete and turn in the following at the end of the rotation:
- Clinic Log
- Student Evaluation of the Clerkship (online)
- Video recorder, if applicable
12. If you are registered at the med school to receive special accommodations at the final exam, it is your responsibility to provide this information to Claire Ann Boyce by PCC Week 3 so appropriate arrangements can be made.
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12 - PCC Final Exam
There are four components to the final exam:
- OSCE exam: 25% of final grade
- On-line Closed Resource multiple choice exam: 5% of final grade
- Open Resource on-line multiple choice exam: 5% of final grade
- Open Resource short answer/essay exam: 5% of final grade
- OSCE - Last Thursday AM of the Rotation, (see email from Claire Ann Boyce) HSLC Room 1188 (25% of final grade)
The OSCE is a clinical or practical examination. Each station tests performance of a set of clinical skills from the clerkship objectives. Students are provided with a brief case scenario and specific tasks to complete. The student then interacts with a standardized patient trained to provide a similar experience for each student. One faculty observer is present and uses a checklist of competencies to evaluate the student's performance. Currently, the PCC OSCE consists of 6 stations, each lasting 10-12 minutes. Examples of skills that might be tested are: delivery of a problem assessment, negotiating a treatment plan, performing a focused physical exam, taking the history of a common primary care problem. - Proctored, Closed Resource Exam (one hour): Last Thursday, 11:30-12:30, HSLC Room 1306, 5% of final grade
Immediately after the OSCE, students will take a short closed resource, aka ‘shelf’ exam. This exam consists of 30 multiple choice questions designed to evaluate the knowledge and problem-solving skills students that are expected to learn on the clerkship. It is timed, but not designed to be time-constrained. - On-line (Learn@UW), "Open Book" Exam (3.5 hours)
The on-line exam is available from 11 am on the last Thursday through 6 pm the last Friday of the Clerkship.There are two parts of this exam. Students may take the parts in any order; one right after another, or with breaks in between. The exam is open-reference to allow students to use references with which they are familiar. There are time limits on the exam parts, so students will benefit from being facile with using on-line resources or creating their own. The use of the cases and questions forum should be helpful. Students cannot use other people for help. - Part 1 - Multiple Choice Question Exam (one hour): 5% of final grade
There are about 30 single-best-answer multiple choice questions and 4 multiple-multiple choice questions in which there are more than one correct answer among the choices for the question.
- Part 2 - Written Exam (2.5 hours): 5% of final grade
a) (one hour) Four short-answer questions ask students to apply evidence-based medicine principles to a clinical problem.
b) (1.5 hours) Modified-Essay Quiz (MEQ): series of short-answer questions based on a clinical case. Students are given a portion of case information and are asked about the next step in managing the case.
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13 - Evaluation and Grading
You will be responsible for demonstrating competency in the core learning objectives on the final exam whether they are taught via Problem-Based Learning (PBL), in the clinical setting or independent study.
Near the end of the rotation, your primary clinical preceptors and other preceptors who have worked with you more than three half-days will be required to evaluate your clinical performance using a standardized clinical evaluation form. If you work with many preceptors at a clinic, the primary preceptor will often summarize the evaluation ratings for the clinic.
Those grading you will receive an evaluation form and an accompanying grid for guidance.
| Advanced | Competent | Needs Improvement | Unacceptable: Requires Remediation | Not Evaluated |
Typically, preceptors grade students as "Competent" or "Needs Improvement" unless the student has exemplary performance. If a preceptor's verbal feedback has been "You are doing great!!" it does not necessarily meant the preceptor will check boxes under "Advanced". It is the student's responsibility to elicit comprehensive feedback.
Each clinical preceptor who has worked with the student more than three half-days will evaluate the student's clinical performance, using the clinical evaluation form supplied by the Medical School's office. The small group leader will evaluate the student's performance in the Problem Based Learning sessions using the mentor evaluation form.
Each preceptor evaluation is weighted, based on the number of half-days with the student. In other words, the evaluation from a preceptor who worked with a student for 21 half days will count more than an evaluation from a preceptor who worked with a student for 6 half days. The final grade is determined by the Clerkship Director.
Because PCC final grades are determined by a number of carefully selected components, it is rare that a final grade is changed. If you have concerns about your grade, contact Claire Ann Boyce. If you wish to review the specific results of your OSCE or online exam, contact Doug Smith, MD. Only if you are able to provide new or revised information about your performance will a grade change be considered. These requests should be submitted in writing and with appropriate documentation to the PCC Director, John Brill, MD
Final Grade:
50% Clinical (average of all preceptors)
10% Problem Based Learning and Dr/Pt Communication sessions
40% Final Exam (half OSCE, half written exam)
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14 - PCC Course Administration
Director:
John Brill, MD
john.brill.md@aurora.org
(608) 265-8406
Statewide and Madison Administrator :
Claire Ann Boyce
claire.boyce@fammed.wisc.edu
(608) 263-0427
15 - PCC FAQ's
Why do we have to track the ‘Core Conditions’?:
The Liaison Committee for Medical Education (LCME) is the accrediting body for US allopathic medical schools. In its recent Second Educational Directive (often referred to simply as ‘ED-2’), the LCME created a number of requirements. Among these were a requirement that each student rotation define the types of patients and clinical conditions that each student MUST encounter during the rotation, what simulated experiences would be used if these clinical encounters were not available, and what tracking system would be used to ensure that all students have the required experiences.
The UWSMPH is preparing for a fall 2009 re-accreditation visit by the LCME. During the spring of 2008 each clerkship was asked to create a list of up to 10 Core Conditions that each student must encounter. The clerkship directors then reviewed for list for redundancy and inclusiveness. In this process, some clinical conditions that overlap were assigned to one or another clerkship. For example, ‘back pain’ and ‘headache’ were on the original lists created by both Neuroscience and Primary Care. In discussing the curricula, the directors determined to assign ‘back pain’ as a Core Condition for Neuroscience, since it is a specific focus of that clerkship, and ‘headache’ to the Primary Care Clerkship.
What are the criteria for ‘counting’ a Core Condition?
Any direct clinical contact with one of the Core Conditions, including observation, can be counted as meeting the requirement, and thus be tracked on OASIS.
Why is there a difference between the topics of the Learning Objectives and the Core Conditions?
The Learning Objectives constitute the curricula for the rotation; they are derived from the rotation educational goals and are composed of the most frequently encountered visit types in primary care practice as well as the tools to support these visits. Students should be familiar well and expect evaluation in these areas.
Symptomatic Conditions
1. Abdominal Pain
2. Back Pain
3. Chest Pain
4. Vaginal/Urinary Symptoms
5. Headache
6. Musculoskeletal
7. Acute Respiratory Infections
Chronic Diseases
1. Hypertension
2. Asthma/Chronic Lung Disease
3. Depression
4. Diabetes
Systems of Care & Learning
1. Evidence-Based Medicine (EBM)
2. Doctor Patient Communication
3. Preventive Services
4. Primary Care and Public Health
5. EKG interpretation
The Core Conditions are a subset of these topics that the clerkship has selected to track in order to ensure an appropriate variety of learning experiences.
1. Hypertension
2. Diabetes Type 2
3. Depression
4. Asthma/Chronic lung disease
5. Chest pain
6. Headache
7. Abdominal Pain
8. Acute respiratory infection
9. Well Child Check
10. Adult physical or Wellness visit
Thus, while the Core Conditions will be included in the evaluation process, they are not the entirety of the curriculum.
What do I have to include in the tracking on OASIS?
The only requirement is checking that you have experienced the clinical condition or visit type, even if only through observation. A space is provided in OASIS for notes if, for your own learning purposes, you would like to include more information, but this is completely optional.
Why are some of my clinics so far away? Is mileage reimbursement available?
Unfortunately, recruiting volunteer preceptors has become more and more difficult, and we have had to go farther afield from our regional campuses to obtain strong learning sites. This is particularly true in the Madison area, where we regularly use preceptors as far away as Beloit, and in Milwaukee, where Kenosha is a frequent site.
The regional coordinators do take driving distance into account in making preceptor assignments, and do make an attempt to limit driving through assignment and schedule adjustments. However, since continuity of care is one of the major learning goals of the PCC, it is not possible to make driving distances completely equal for every student.
With escalating gasoline prices, the cost involved clearly becomes a significant financial burden. We regret that mileage reimbursement is not available through the UWSMPH for student commutes to training sites.
A national survey of primary care clerkships done in early 2008 did not identify any schools that reimburse students for driving unless this was funded through an external source, such as AHEC.
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