A required fourth-year ambulatory clerkship: a 10-year experience with family practice and primary care internal medicine sites.

Authors of recent articles have suggested increasing medical student experiences in ambulatory primary care settings to enhance general medical education and increase student interest in family practice. The University of California, San Francisco, a large, tertiary-care medical school, has operated a required ambulatory primary care clerkship for fourth-year medical students for 10 years. The clerkship uses both family practice and general internal medicine clinic sites and, since 1980, has been coordinated by the UCSF Department of Family and Community Medicine. Students have consistently rated the clerkship positively. The clerkship appears to have helped maintain the level of graduating students entering primary care residencies. Our report describes clerkship activities at both family practice and primary care internal medicine residency sites. We examine student evaluations of the experience, the potential effects of the clerkship on residency and career choices, and the advisability of implementing a joint departmental clerkship.