Learning to be a doctor: Medical students' perception of their roles in longitudinal outpatient clerkships

Objective: To understand how medical students perceive their roles in early longitudinal primary care clerkships. Methods: Medical students enrolled in one of two longitudinal primary care clerkships-Education-Centered Medical Home (ECMH) or Individual Preceptorship (IP)-participated in semi-structured interviews. Interviews were recorded, transcribed, and analyzed using a grounded theory and constant comparative approach. Results: Students (N = 35) in both clerkships perceived benefits of early clinical exposure, reflecting positively on having time to interact with patients. Identified roles ranged from shadower to collaborator to diagnostician; a progression from position-centered to more patient-centered roles emerged. ECMH students also identified as health educators, care managers, and mentors. IP students described the clerkship primarily as an opportunity to acquire clinical knowledge and practice skills, expressing perceptions of being a transient visitor in the clinic, whereas ECMH students reported taking an active role in continuity care of patients. Conclusion: Students identified benefits of early longitudinal outpatient primary care clerkships, supporting the inclusion of these experiences within medical school curricula. Clerkships with an emphasis on longitudinal and team-based care may further promote student participation in patient care and professional development. Practice Implications: Longitudinal, team-based early clinical experiences may best promote student involvement in patient care. (C) 2018 Elsevier B.V. All rights reserved.