ABSTRACT
Two important goals of clinical training in medicine are to teach interns to become competent professionals and to ensure that patients receive quality care. In training programs in ambulatory clinics in the United States, medical consultations are structured with the dual goals of teaching and patient care. After a medical intern takes history and examines a patient, he or she presents the case and discusses it with a supervising physician, called a preceptor. The preceptor then may see the patient. In some circumstances, it is institutionally and/or legally mandated for the supervising physician to gather firsthand information on the patient’s condition; in other circumstances, it is discretionary. When the preceptor sees the patient, the intern is present in the examining room and participates to a greater or lesser extent with the patient and the preceptor. On the more participatory side, an intern may interject information he or she previously elicited or inquiry about areas of the patient’s history that need clarification. On the less participatory side, an intern may situate him or herself on the sidelines and minimally acknowledge information that the patient gives to the preceptor. When the preceptor concludes the interaction with the patient, the preceptor and intern leave the examining room and confer again. After conferring, the intern returns to the patient to discuss diagnosis and treatment plans.
