A comparison of clinical pediatric patient encounters in university medical center and community private practice settings

Background. - Growing numbers of medical students complete clerkships in community private practice (CPP) settings instead of the more traditional university-based clinics, yet few empirical studies have evaluated how setting type impacts clinical experiences, skill development, and student satisfaction. Objective. - This study compared the pediatric patient encounters seen by third-year medical students in university medical center (UMC) and CPP settings. Methods. - Third-year medical students were required to keep a log of all patients seen during their 8-week pediatric clerkship. Logbook entries were coded and then analyzed for differences in the number and distribution of the primary diagnostic categories between settings. Results. - CPP students reported, on the average, seeing over 3 times more patients than UMC students. The case mix distribution also differed significantly by setting. In general, CPP students reported seeing proportionately more routine illnesses, whereas UMC students reported seeing proportionately more uncommon disorders. Because CPP students saw more patients overall, they averaged more cases in almost all diagnostic categories. Conclusion. - CPP students received more clinical patient exposure than UMC students, except for patients in a few diagnostic categories.