Physician, Patient, and Society
The Physician, Patient and Society course aims to have students achieve competencies in the areas of personal and professional development, continuous teaching and learning, the medical interview, physical examination, clinical problem solving including integration of basic science material and use of specific analytic and assessment principles contained within epidemiology, community health, and medical ethics, all geared toward enhancing students' skills in the content and process of patient care. The course has 3 main components, PPS small groups made up of 2 faculty members, and 9-11 students, the Longitudinal Preceptor Program (LPP), where students work alongside a practicing doctor, practicing the skills taught in the small group, and the Physical Diagnosis course, in which the principles of the normal and abnormal physical examination are taught and practiced.
S1-164 in the Office of Undergraduate Medical Education
Faculty and Staff
David S. Hatem, M.D., Director
Ann Perla, Administrative Manager
Ann M. Perla: (508) 856-6107
The Physician, Patient and Society (PPS) course allows students to see the end point of their study from nearly the first day of medical school. The skills taught in the Physician, Patient and Society (PPS) course include those of the Medical Interview, stressing the 3 major functions of this endeavor, gathering data, establishing and maintaining patient relationships, and educating the patient, the physical exam, clinical reasoning and problem solving, medical ethics, community medicine and public health, teaching and learning for development as a lifelong learner, and personal a professional growth.
By the end of the course, students are expected to be able to collect a complete history from a patient; perform a complete and accurate physical examination; deliver an oral presentation of their patient's history and physical examination to their preceptor; record a complete write-up which details what they think is occurring in the patient, and their further plan for diagnostic testing or treatment. This course also encourages students to look for disease, utilizing their developing knowledge of pathophysiology, gather information which incorporates data about the patient's life context, and consider the care that they will deliver in the context of an increasingly complex care system. PPS visits and reinforces the skills of caring, concrete, reproducible behaviors which complement their scientific knowledge and allows for the creation of a meaningful, and healing relationship between students and their teachers, students and their patients, and students and the broader communities in which they work.
A key feature of this course is that it is integrated and longitudinal. The longitudinal nature of the course allows the students to learn basic skills (i.e. basic interviewing techniques) early and sequentially build on these skills as time goes on to take on progressively more difficult tasks (performing a geriatric interview, obtaining a sexual history, delivering bad news). The integrated nature of the course allows key collaboration between the Basic Science courses in years 1 & 2 and PPS, so that students can apply information that they have learned to concrete learning and practice situations. This integrative nature of the course is essential to its success, demonstrating that the distinctions between courses are artificial, and that physicians need to call on knowledge from multiple areas to solve clinical problems.
Two other aspects of the course, the Longitudinal Preceptor Program (LPP) and the Physical Diagnosis (PD) course function as veritable practice laboratories, places where students see how the skills they are taught are practiced in the real world. Each of these is offered in both year 1 and year 2. In the LPP, students see patients alongside a practicing physician who is generally from a primary care specialty. They visit the practice approximately every other week during their first two years of medical school. Their work there begins as a shadowing experience, witnessing the work of the practice of medicine, and it increasingly becomes one in which they actively practice the skills which they have been taught in their small groups. The PD course also uses skills practice as its mainstay. Lectures demonstrate the basic skills, and are followed by practice of these skills in both PD 1 and 2.