Changing the fourth-year medicine clerkship structure: a successful model for a teaching service without housestaff.

The fourth-year medicine clerkship was restructured at one of four sites. Teams consisting of one attending physician and three students cared for eight new patients per week. The overall experience of the restructured clerkship was rated significantly more positively than the experiences at all other sites and the teaching effectiveness of the faculty more positively than those at two of the other sites. This clerkship structure was perceived by students to be a positive experience. It could serve as a model for housestaff training programs to successfully care for patients without housestaff.