Clinical content of the WAMI community clerkship in family medicine.

Student experience with diagnostic encounters and clinical procedures was documented in the WAMI Program's Community Clerkship in Family Medicine from 1974 to 1978. This six-week senior clerkship was completed by 234 students and taught in six family practicees across the four-state WAMI (Washington, Alaska, Montana, Idaho) region. Students encountered a mean of 83 diagnostic problems and 22 procedures weekly. The average student saw 56 percent of the diagnoses common in family practic and performed 26 percent of the common procedures. The mean level of student responsibility (self-rated with 3 = independent management, 2 = assisted, and 1 = observed) was 2.7 for diagnostic encounters and 2.4 for procedures and increased over the four years. Despite the wide geographic separation and diversity of teaching sites, few differences were observed among the sites; this suggests that a community-based family medicine clerkship can be taught in a widely scattered network of rural teaching practices with uniformity of clinical content and educational quality.