title: Clinical exposure during clinical method attachments in general practice.
abstract: BACKGROUND
  There has been a significant decline in medical students' clinical experience in hospitals. Hospital-based teaching is struggling to provide medical students with sufficient experience of the common health problems of our industrialized ageing society. Hence, general practice has become an important locus for medical education. Published evidence, however, that students can access appropriate clinical experience in general practice is sparse.
  
  
  OBJECTIVE
  To determine students' clinical exposure during clinical and method attachments based in general practice at two medical schools. EDUCATIONAL INITIATIVE: Students were attached to general practice tutors to learn clinical method in internal medicine.
  
  
  METHODS
  General practice tutors from two medical schools collected data on age, gender, diagnoses, symptoms and signs of the patients they invited to teaching sessions.
  
  
  RESULTS
  The frequency of diagnoses, symptoms and signs seen by medical students are recorded. Students mostly saw patients with chronic illnesses; the commonest diagnoses were ischaemic heart disease and angina.
  
  
  CONCLUSIONS
  Our study has recorded the largest published database of clinical diagnoses, symptoms and signs encountered by students learning clinical method in general practice. It shows that students obtained a wealth of experience with patients with common chronic diseases. Students must also learn in the hospital setting, to experience the presentation of acute illness. The combination of teaching in these two settings is likely to provide the most effective technique to ensure that students encounter the common, acute and chronic conditions that affect patients in the 21st century.
authors.affiliation: Royal Free and University College Medical School, University College London, Department of Primary Care and Population Sciences, London, UK. p.bryant@pcps.ucl.ac.uk
authors.forename: Pauline
authors.initials: P
authors.lastname: Bryant
authors.forename: Sarah
authors.initials: S
authors.lastname: Hartley
authors.forename: Will
authors.initials: W
authors.lastname: Coppola
authors.forename: Anita
authors.initials: A
authors.lastname: Berlin
authors.forename: Michael
authors.initials: M
authors.lastname: Modell
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Murray
mesh_terms: D002982:Clinical Clerkship / Q000592:standards; D002983:Clinical Competence / Q000592:standards*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods* / Q000592:standards; D005194:Family Practice / Q000193:education* / Q000379:methods; D006784:Hospitals, Teaching; D006801:Humans; D013663:Teaching / Q000379:methods