A word on switching preceptors

Last semester, I found myself in the unfortunate position of not being satisfied with my preceptorship experience. We were semi-randomly matched to a physician, either associated with the University or out in the community, usually in a specialty that would afford us opportunities to practice general patient interaction skills and be exposed to a range of different patients (Family, OB/Gyn, Peds, Emergency, Internal).

I matched with a doctor practicing occupational medicine, which basically involves seeing patients who were injured on the job. There's also usually some sort of legal involvement: a lawsuit against the employer, requiring the doctor's signature to allow the patient to return to work, or something along those lines.

Being at the nexus of medicine and two arcane systems of law (Federal and State), there were many aspects of occupational medicine that I frankly found distasteful. First, in some circumstances, doctor-patient confidentiality does not exist. My preceptor sometimes had to preface a question by saying, "Now you don't have to answer this because my records are not confidential..." To me, taking away that privileged relationship between doctor and patient subtly shifts the role of the doctor away from first and foremost caring for the patient's health. The societal role that my old preceptor filled is a necessary one, but I didn't have any interest in spending the next two years of my preceptorship in that environment.

There were other consequences of being caught in middle of a tug-of-war between medicine and law. My old preceptor counseled some of his patients that they may be followed or videotaped by their employers who hope to prove that their injuries were not as severe as they claimed. Also, in order to determine how much worker's compensation should be given to a man with a rotator cuff injury, the deficit in the shoulder's range of motion was measured and applied to arbitrary guidelines imposed by the State and Federal governments. Again, I just didn't have any interest in gaining more exposure to that kind of medicine.

I feel it's important to emphasize that, personally, I very much liked my old preceptor. He seemed to enjoy his role as mentor, and I learned a lot from him. I felt bad telling him that I would no longer be coming in; it was like a break-up conversation. But at the end of the day, this is my medical education, and I need to do whatever is in my power to make the most out of it.

Finding a new preceptor

Finding a new preceptor on my own was a lot more difficult than I thought it would be. My strong preference was to work in the emergency room environment, but I kept an open mind to other possibilities, as well. After striking out with several promising leads, I began to grow discouraged about my prospects of finding a new preceptor.

Then, at the end of last semester, I attended a sonography workshop hosted through the Emergency Medicine Interest Group. Afterward, I approached the doctor who ran the workshop, explained that I was looking for a new preceptor, and asked if he knew if any of his colleagues might be interested. "I'll take you," he said, and that is how I met my new preceptor.

I feel very fortunate to be working with Dr. Browne.