July 23, 2009

The Pre-Clinical Clerkship

Dear Students,

You will soon be starting medical school, your first step toward becoming a doctor.  One of the most important courses in our medical school, which will teach you the "art of medicine," is the Pre-Clinical Clerkship.  In this course, you will learn the skills needed to approach patients, examine them, and understand the important role of a student doctor in a patient’s care.  The sessions and tutorials in this course will prepare you for your clinical clerkships, which occur in third year.  All of the sessions in this course are designed to build clinical skills and offer you the opportunity to observe or practice specific skills.

In order to start you on your path toward the acquisition of these skills, you will be asked to do four things during the summer or the first few weeks of medical school:

(1) During the first few weeks of school, you will be asked to form a tutor group (four students to a group) for the purpose of being assigned to a clinical tutor(s) who will meet with you once a week outside the formal Pre-Clinical Clerkship sessions.  These tutors, all experienced clinicians, will take you to see patients and give you opportunities to practice the skills you will be acquiring in the formal sessions.  Sometimes you will be interviewing patients; sometimes you will be learning the physical exam on each other and then on patients.  Three afternoons a week have been freed up in the weekly schedule so you have ample time to meet with your tutor weekly.  You will continue these weekly tutorials throughout the academic year for two years to prepare you for your clinical experience on the wards.  You may have to take a bus or drive to your tutor's hospital. Money has been earmarked in your scholarship and loan accounts to pay for transportation to the tutor’s office, if needed.   These tutorials, along with the course sessions constitute your Pre-Clinical Clerkship.

(2) The official textbook for the course is Bates’ Guide to Physical Examination and History Taking, 10e by Lynn S. Bickley.*  We strongly suggest that you purchase this book for the course.

(3) You will need to buy a set of instruments that will serve as tools you will use to learn the physical exam.  A list of needed instruments will be sent to you after you start.  The highest priced items include a reliable stethoscope and an ophthalmo-otoscope.  The total sum of these instruments could come as high as $600.  However, I would like to remind you that these will be your tools for performing physical exams and should be looked at as an investment that will serve you for a lifetime. You will receive guidance as to the best deal you can get and we will schedule an Equipment Fair, when venders come to Yale to display and sell this equipment. Money has been allocated in your scholarship and loan accounts for the purchase of these instruments. 

(4) One of the fall sessions of the Pre-Clinical Clerkship will expand on your understanding of the psychosocial factors that impact on a patient’s illness, issues raised by reading about the Hmong. Over the summer, we want you to interview someone in your family who has experienced an illness and write a short (approximately 1200 words) report on how psychosocial factors may have impacted on her (his) perception of illness.  Click here for this assignment. 

This is an exciting time for you and a time that I hope is filling you with more joy than anxiety.  Just remember that anyone who gets accepted into Yale School of Medicine and really wants to become a doctor always reaches this goal.  It takes dedication, hard work, and motivation.  I look forward to meeting you all and to start your training in the clinical skills needed to become the doctor I know you all want to be. 

Sincerely,

Margaret Bia, M.D.

Professor of Medicine

Course Director, Pre-Clinical Clerkship

Director of Clinical Skills Program

* We used to use Swartz Textbook of Physical Diagnosis, but have switched this year to Bates because it has a better physical exam with more anatomy.