By Adrian N. Billings, MD, PhD, FAAFP
Why do I precept medical students? Luckily, I ask myself this question less and less frequently because I enjoy having these junior colleagues with me, especially at 2 a.m. while delivering babies. However, I recently explored this question with some reflection on my past seven years of precepting around 100 medical students and 20 resident physicians in my practice.
Unequivocally, the answer to the preceding question is that I precept medical students because my patients receive better care if I have a medical student working with me. It does not matter how fresh a medical student is into clinical training, two sets of eyes and two sets of brains examining and thinking about a patient’s problem are better than my own brain by itself. I have had preclinical students consider and make diagnoses that I have not been able to. Even if the students don’t make the correct diagnosis and they hear zebra hoofbeats instead of horse hoofbeats, this mental task causes me to consider a broader and more thorough differential diagnosis with their valuable input. I consider it an honor and privilege to be entrusted by medical schools with these young student physicians.
I also precept medical students because of the Hippocratic Oath. When I took the Hippocratic Oath as a medical student I held it as one that is binding and sacred to my role as a physician to society to include “treat the sick to the best of one’s ability, preserve patient privacy, teach the secrets of medicine to the next generation.”
I firmly believe I am a better physician because of my role as a medical student preceptor. Medical students challenge me on a daily basis for academic answers to their questions. I am comfortable in my own skin enough to know I do not have all the answers, and when I don’t, that’s when the medical student is assigned homework and we review that lesson and answer the next day.
My patients by in large enjoy the medical students’ enthusiasm, attention, and extra time they spend with the patients. My practice is accustomed enough to me hosting medical students that my patients and staff miss them when we do not have one rotating with our practice. I miss the students as well when they are not present.
Also, I have found that I am more efficient when working with a medical student alongside me. Additionally, my day is more interesting and fun with medical students around.
I initially began hosting medical students when I was in solo private practice because I was lonely and missed the camaraderie of medical school and residency. The selfish side of me wanted to find a future partner to share hospital call with. My community and I have been blessed to have three former trainees return to practice in the Big Bend with me. Medical students are a great investment and we should invest our time and energies in them.
I want to open the door for medical students to rotate with me in a federally qualified health center in one of the most medically underserved areas of Texas, which has limited health care resources. This demonstrates to them the full potential of a family physician who practices full spectrum family medicine, from cradle to grave, including house calls. My hope for them is that they work with a physician who loves his or her job and practice, and they see how important and vital a family physician is to their patients and community. For many of these students, this rotation will be their only exposure to this kind of domestic missionary medicine and my hope is that all of them will become family physicians.
However, they all will not enter family medicine nor even primary care. Perhaps, these future physicians will have a healthier respect for the challenges underserved patients and their primary care physicians have if they ultimately become a specialist physician. Maybe, later in their career, if they are practicing at a larger tertiary care hospital as a specialist and they get that 2 a.m. telephone call for help from me or someone like me, they will remember their rural, underserved family medicine experience and have a better understanding of the challenges of family medicine.
Please volunteer to precept medical students. It does not matter whether you practice in Pampa or Plano, in direct primary care or in a federally qualified health center, or whether you include hospital medicine or obstetrics in your practice, you are needed as a mentor to these student physicians. Once you have precepted medical students in your practice, the rewards are tremendous and my hope is that you feel as I do, incomplete, without a young enthusiastic and brilliant medical student shadowing you.
Thank you for all you do for our profession.
Billings is the director of the Texas Statewide Family Medicine Preceptorship Program.