1. Texas Academy of Internal Medicine Welcome Congratulations! You have almost finished – and survived – your first year of medical school. You are about to begin an exciting, low-stress, and fun clinical experience with your placement in the GIMSPP. Congratulations! You have almost finished – and survived – your first year of medical school. You are about to begin an exciting, low-stress, and fun clinical experience with your placement in the GIMSPP.

2. Texas Academy of Internal Medicine Welcome You can be proud of your acceptance into the program, as each year the selection process is increasingly more competitive. You can be proud of your acceptance into the program, as each year the selection process is increasingly more competitive.

3. Texas Academy of Internal Medicine Welcome During your preceptorship: You will practice new clinical skills, interact with patients, work as a team with other health care professionals, and gain first hand insight into the life of an internist. During your preceptorship: You will practice new clinical skills, interact with patients, work as a team with other health care professionals, and gain first hand insight into the life of an internist.

4. Texas Academy of Internal Medicine Getting Started

5. Texas Academy of Internal Medicine Getting Started Before you begin: 1.Take a few minutes to reflect on WHY you have chosen to do this preceptorship. 2.Develop your personal goals before your first day. 3.Outline in advance what you expect to gain from your work this summer. Before you begin: 1.Take a few minutes to reflect on WHY you have chosen to do this preceptorship. 2.Develop your personal goals before your first day. 3.Outline in advance what you expect to gain from your work this summer.

6. Texas Academy of Internal Medicine Getting Started Your preceptor has a copy of your application and knows your current clinical skills level, interests, learning style, and objectives. The GIMSPP has provided this to him or her to better meet your needs. Your preceptor has a copy of your application and knows your current clinical skills level, interests, learning style, and objectives. The GIMSPP has provided this to him or her to better meet your needs.

7. Texas Academy of Internal Medicine Getting Started Your first preceptor contact is important ! Approximately two weeks before your rotation begins, call the preceptor’s office, introduce yourself, and ask the preceptor’s nurse or office manager to set a time when you can call the preceptor. Your first preceptor contact is important ! Approximately two weeks before your rotation begins, call the preceptor’s office, introduce yourself, and ask the preceptor’s nurse or office manager to set a time when you can call the preceptor. You must remember, first impressions are important. Call back at the date and time given to you, and be well prepared when you call.

8. Texas Academy of Internal Medicine Getting Started Questions to ask: 1.Verify the dates of your rotation as stated in your confirmation letter. 2.Ask where and at what time you should meet. If possible, schedule 30 minutes or so on your first day to discuss your goals, the Learning Contract (discussed later in the program), and expectations with your preceptor. 3.Does your preceptor have specific days off each week? (continued) Questions to ask: 1.Verify the dates of your rotation as stated in your confirmation letter. 2.Ask where and at what time you should meet. If possible, schedule 30 minutes or so on your first day to discuss your goals, the Learning Contract (discussed later in the program), and expectations with your preceptor. 3.Does your preceptor have specific days off each week? (continued)

9. Texas Academy of Internal Medicine Getting Started Questions to ask: 4.Will you accompany him or her on weekend call? 5.What are your preceptor’s office hours? 6.What hours will you be working? (The GIMSPP will accept whatever hours your preceptor sets.) 7.Is there a dress code? 8.Obtain directions to office and parking. 9.If applicable, what are the housing arrangements. Questions to ask: 4.Will you accompany him or her on weekend call? 5.What are your preceptor’s office hours? 6.What hours will you be working? (The GIMSPP will accept whatever hours your preceptor sets.) 7.Is there a dress code? 8.Obtain directions to office and parking. 9.If applicable, what are the housing arrangements.

10. Texas Academy of Internal Medicine Getting Started Most preceptors in our program are experienced teachers who have trained many students. Preceptors are NOT paid to teach medical students; they do it because they are committed to your education. Always remember that you are a guest in your preceptor’s practice.

11. Texas Academy of Internal Medicine Getting Started Understand that you have made a commitment to your preceptor for the dates mentioned in your confirmation letter. It is important for you to honor this commitment unless you have unavoidable circumstances. In such an event, contact the GIMSPP office immediately. It would be courteous of you to notify your preceptor as well. Understand that you have made a commitment to your preceptor for the dates mentioned in your confirmation letter. It is important for you to honor this commitment unless you have unavoidable circumstances. In such an event, contact the GIMSPP office immediately. It would be courteous of you to notify your preceptor as well.

12. Texas Academy of Internal Medicine Your First Day

13. Texas Academy of Internal Medicine Your First Day Items needed on your first day: Your GIMSPP nametag Any books that you need for clinical reference (such as Bates’, Harrison’s, or Cecil) Your stethoscope Appropriate clothes for a professional practice Comfortable shoes, as you will be on your feet much of the day Items needed on your first day: Your GIMSPP nametag Any books that you need for clinical reference (such as Bates’, Harrison’s, or Cecil) Your stethoscope Appropriate clothes for a professional practice Comfortable shoes, as you will be on your feet much of the day

14. Texas Academy of Internal Medicine Your First Day When you arrive, it is very important that you meet the office staff. Take a few minutes to go around the office and introduce yourself to EVERYONE. Try to understand each person’s role in the practice. Learn about the responsibilities of the other health care providers. When you arrive, it is very important that you meet the office staff. Take a few minutes to go around the office and introduce yourself to EVERYONE. Try to understand each person’s role in the practice. Learn about the responsibilities of the other health care providers.

15. Texas Academy of Internal Medicine Your First Day Learn your Preceptor’s teaching style. Some will prefer that you “shadow” them as they see patients, so that you and the preceptor will examine patients together. Learn your Preceptor’s teaching style. Some will prefer that you “shadow” them as they see patients, so that you and the preceptor will examine patients together.

16. Texas Academy of Internal Medicine Your First Day Others will encourage you to interview patients on your own and present your findings to your preceptor, with both of you finishing the patient encounter together. Your preceptor will decide, with your input, which approach seems appropriate. Note: This is a good goal to discuss in the Learning Contract. Others will encourage you to interview patients on your own and present your findings to your preceptor, with both of you finishing the patient encounter together. Your preceptor will decide, with your input, which approach seems appropriate. Note: This is a good goal to discuss in the Learning Contract.

17. Texas Academy of Internal Medicine During Your Rotation

18. Texas Academy of Internal Medicine During Your Rotation Whenever possible, you should accompany your preceptor: - on hospital rounds - on calls - to medical meetings - to CME functions - to community events The reason is so that you can observe the many different aspects of a physician’s life. Whenever possible, you should accompany your preceptor: - on hospital rounds - on calls - to medical meetings - to CME functions - to community events The reason is so that you can observe the many different aspects of a physician’s life.

19. Texas Academy of Internal Medicine During Your Rotation Remember, you have knowledge and skills to contribute, too. Preceptors tell us they often learn things from their students. Share your skills with them. Be assertive - Don’t hesitate to COMMUNICATE your needs and learning objectives with your preceptor. Make your wishes known but be flexible. Ask questions - Offer to help in any way possible – you can be a big benefit to the practice! Remember, you have knowledge and skills to contribute, too. Preceptors tell us they often learn things from their students. Share your skills with them. Be assertive - Don’t hesitate to COMMUNICATE your needs and learning objectives with your preceptor. Make your wishes known but be flexible. Ask questions - Offer to help in any way possible – you can be a big benefit to the practice!

20. Texas Academy of Internal Medicine A Reminder about HIPAA: Chances are you already have heard a great deal about HIPAA, the Health Insurance Portability and Accountability Act of 1996. Physicians were required to activate their privacy policies and procedures by April 14, 2003. Guarding the privacy of patient information is part of your job, too. A Reminder about HIPAA: Chances are you already have heard a great deal about HIPAA, the Health Insurance Portability and Accountability Act of 1996. Physicians were required to activate their privacy policies and procedures by April 14, 2003. Guarding the privacy of patient information is part of your job, too. During Your Rotation

21. Texas Academy of Internal Medicine Confidentiality is stressed where medical records are concerned, and you need to be especially vigilant not to leave patient information lying around where others can see it. For example, faxing patient records to a wrong number or discussing patient history where you might be overheard, such as in an elevator or common area, are situations that you should be careful to avoid. You must consider privacy when dealing with medical information, simply out of respect for the patient, as well as to keep on the right side of the law. Confidentiality is stressed where medical records are concerned, and you need to be especially vigilant not to leave patient information lying around where others can see it. For example, faxing patient records to a wrong number or discussing patient history where you might be overheard, such as in an elevator or common area, are situations that you should be careful to avoid. You must consider privacy when dealing with medical information, simply out of respect for the patient, as well as to keep on the right side of the law. During Your Rotation

22. Texas Academy of Internal Medicine Resources

23. Texas Academy of Internal Medicine Resources The GIMSPP provides several tools to serve as resource materials during your rotation: By now, you should have received your copies of the pharmacology book and history and physical pocket guides. (If not, please notify the GIMSPP administrator immediately.) Other resources are the Learning Contract, Daily Log Book, and Student Evaluation of Preceptor and Program. The GIMSPP provides several tools to serve as resource materials during your rotation: By now, you should have received your copies of the pharmacology book and history and physical pocket guides. (If not, please notify the GIMSPP administrator immediately.) Other resources are the Learning Contract, Daily Log Book, and Student Evaluation of Preceptor and Program.

24. Texas Academy of Internal Medicine Resources The Learning Contract Each student has different interests, needs, skill levels, and background. So does each preceptor. The preceptor exposes the student not only to the preceptor’s own talents, philosophies, and clinical skills, but also to the unique demographics and characteristics of their patients, practice, and community. (continued) The Learning Contract Each student has different interests, needs, skill levels, and background. So does each preceptor. The preceptor exposes the student not only to the preceptor’s own talents, philosophies, and clinical skills, but also to the unique demographics and characteristics of their patients, practice, and community. (continued)

25. Texas Academy of Internal Medicine Resources To help bring all these traits and circumstances together and fashion a valuable, educational experience for both student and preceptor, many use a tool called a Learning Contract. This is a written agreement, negotiated between student and preceptor early in the rotation. (continued) To help bring all these traits and circumstances together and fashion a valuable, educational experience for both student and preceptor, many use a tool called a Learning Contract. This is a written agreement, negotiated between student and preceptor early in the rotation. (continued)

26. Texas Academy of Internal Medicine Resources The Learning Contract will outline the student’s expectations for the preceptorship and serves as a guideline for the preceptor’s final evaluation of the student’s skills and potential according to specified performance goals. (continued) The Learning Contract will outline the student’s expectations for the preceptorship and serves as a guideline for the preceptor’s final evaluation of the student’s skills and potential according to specified performance goals. (continued)

27. Texas Academy of Internal Medicine Resources A performance goal is a statement of intent or purpose that sets out in observable and measurable terms the performance expected of the student and/or preceptor; Realistic criteria for successful completion of the goal (what, how, where, and when) and consequences of performing successfully to reach the goal – or of not doing so; and Conditions necessary to perform as expected. (continued) A performance goal is a statement of intent or purpose that sets out in observable and measurable terms the performance expected of the student and/or preceptor; Realistic criteria for successful completion of the goal (what, how, where, and when) and consequences of performing successfully to reach the goal – or of not doing so; and Conditions necessary to perform as expected. (continued)

28. Texas Academy of Internal Medicine Resources You may print out the Learning Contract form by going to: You should develop and agree upon it as early as possible in the preceptorship. (continued) You may print out the Learning Contract form by going to: You should develop and agree upon it as early as possible in the preceptorship. (continued) www.taim.org

29. Texas Academy of Internal Medicine Resources How to use the Learning Contract: On the first day, outline goals for the preceptorship on the form. You may list ideas for specific strategies to accomplish the goals. Discuss the program goals and your expectations and suggestions. Following that discussion, the preceptor will list three goals or areas on which they believe you should focus during the ambulatory learning experience, along with specific strategies. (continued) How to use the Learning Contract: On the first day, outline goals for the preceptorship on the form. You may list ideas for specific strategies to accomplish the goals. Discuss the program goals and your expectations and suggestions. Following that discussion, the preceptor will list three goals or areas on which they believe you should focus during the ambulatory learning experience, along with specific strategies. (continued)

30. Texas Academy of Internal Medicine Resources Using the Learning Contract The preceptor will discuss these goals with you. After negotiation and clarification, write a summary of the agreed-upon goals and expectations of the preceptorship. Following one last review together, both you and the preceptor will sign the contract. A written Learning Contract helps you check back during the rotation to verify that you are “on track” and helps you recognize. your progress. Using the Learning Contract The preceptor will discuss these goals with you. After negotiation and clarification, write a summary of the agreed-upon goals and expectations of the preceptorship. Following one last review together, both you and the preceptor will sign the contract. A written Learning Contract helps you check back during the rotation to verify that you are “on track” and helps you recognize. your progress.

31. Texas Academy of Internal Medicine Resources Daily Log Book A Daily Log Book will help you to remember all you learn. For example, you may want to keep notes of your patient encounters on a daily basis. The log can help you document and achieve your goals as stated in the Learning Contract. It can serve as a great reference for you in your second year when thinking back on actual clinical experiences from your preceptorship. To print a copy of the Daily Log Book go to: Daily Log Book A Daily Log Book will help you to remember all you learn. For example, you may want to keep notes of your patient encounters on a daily basis. The log can help you document and achieve your goals as stated in the Learning Contract. It can serve as a great reference for you in your second year when thinking back on actual clinical experiences from your preceptorship. To print a copy of the Daily Log Book go to: www.taim.org

32. Texas Academy of Internal Medicine Resources Student Evaluation At the end of your preceptorship, you must complete the Student Evaluation of Preceptor and Program online at - Or Important Links box, Student Evaluation of Preceptor. Note that evaluations are kept confidential unless specifically requested otherwise by the student. If you indicate “yes,” a copy of the evaluation will be mailed to the physician. You may share one or all three parts of the evaluation with your preceptor. (See checkbox at the end of each part of the form.) (continued) Student Evaluation At the end of your preceptorship, you must complete the Student Evaluation of Preceptor and Program online at - Or Important Links box, Student Evaluation of Preceptor. Note that evaluations are kept confidential unless specifically requested otherwise by the student. If you indicate “yes,” a copy of the evaluation will be mailed to the physician. You may share one or all three parts of the evaluation with your preceptor. (See checkbox at the end of each part of the form.) (continued) www.taim.org

33. Texas Academy of Internal Medicine Resources Filling out the Student Evaluation Part I: Be careful to complete this section accurately: Your stipend and 1099 tax form (if applicable) will be mailed to the address provided on this part of the evaluation. The Clinical Skills Inventory is repeated from your application to document your progress. Part II: This is the specific evaluation of your preceptor/program. Part III: You may provide feedback for your preceptor – what he or she did well, areas for improvement, and additional comments for the preceptor and/or program. Filling out the Student Evaluation Part I: Be careful to complete this section accurately: Your stipend and 1099 tax form (if applicable) will be mailed to the address provided on this part of the evaluation. The Clinical Skills Inventory is repeated from your application to document your progress. Part II: This is the specific evaluation of your preceptor/program. Part III: You may provide feedback for your preceptor – what he or she did well, areas for improvement, and additional comments for the preceptor and/or program.

34. Texas Academy of Internal Medicine Resources Filling out the Student Evaluation Preceptors also complete evaluation forms on their students and the program. The GIMSPP office will issue your stipend only after receiving both evaluations. Encourage your preceptor to fill out the evaluation BEFORE you leave the office to ensure that your stipend is paid in a timely manner. Your preceptor must complete Parts I and II. Your preceptor may complete the evaluation online at Or Important Links box, Preceptor Evaluation of Student. Filling out the Student Evaluation Preceptors also complete evaluation forms on their students and the program. The GIMSPP office will issue your stipend only after receiving both evaluations. Encourage your preceptor to fill out the evaluation BEFORE you leave the office to ensure that your stipend is paid in a timely manner. Your preceptor must complete Parts I and II. Your preceptor may complete the evaluation online at Or Important Links box, Preceptor Evaluation of Student. www.taim.org

35. Texas Academy of Internal Medicine Stipends

36. Texas Academy of Internal Medicine Stipends Please verify the stipend amount on your confirmation letter and call your GIMSPP administrative contact immediately if you believe there is a discrepancy: AREA4 WEEKS3 WEEKS Rural$750$563 Metro$500$375 Please verify the stipend amount on your confirmation letter and call your GIMSPP administrative contact immediately if you believe there is a discrepancy: AREA4 WEEKS3 WEEKS Rural$750$563 Metro$500$375

37. Texas Academy of Internal Medicine Stipends Tax Information The IRS regards a stipend in the amount of $600 or greater as taxable income, and students receiving $600 or more will be required to report their stipend as income on their tax returns. A 1099-Misc form will be mailed to you in January to the address you provide on your evaluation form (where your check is mailed), unless you call and inform us of a change of address. We are NOT tax experts – please consult your tax advisor or call the IRS for information on which forms to complete, etc. Professional Liability Insurance You are covered for professional liability by your school’s insurance policy during your preceptorship. The GIMSPP office can provide a copy of the letter of coverage to your preceptor. Tax Information The IRS regards a stipend in the amount of $600 or greater as taxable income, and students receiving $600 or more will be required to report their stipend as income on their tax returns. A 1099-Misc form will be mailed to you in January to the address you provide on your evaluation form (where your check is mailed), unless you call and inform us of a change of address. We are NOT tax experts – please consult your tax advisor or call the IRS for information on which forms to complete, etc. Professional Liability Insurance You are covered for professional liability by your school’s insurance policy during your preceptorship. The GIMSPP office can provide a copy of the letter of coverage to your preceptor.

38. Texas Academy of Internal Medicine At the Conclusion of Your Rotation

39. Texas Academy of Internal Medicine At the Conclusion of Your Rotation Preceptors are volunteers, so when your rotation ends, please express your appreciation to your preceptor for his or her time and interest in contributing to your medical education. Send your preceptor a brief thank-you note after the conclusion of your rotation. And stay in touch! Preceptors enjoy hearing from their students. Preceptors often serve as mentors for many years. Preceptors are volunteers, so when your rotation ends, please express your appreciation to your preceptor for his or her time and interest in contributing to your medical education. Send your preceptor a brief thank-you note after the conclusion of your rotation. And stay in touch! Preceptors enjoy hearing from their students. Preceptors often serve as mentors for many years.

40. Texas Academy of Internal Medicine At the Conclusion of Your Rotation If you know an internist you think would be a good preceptor, please contact us with your recommendation at: If you know an internist you think would be a good preceptor, please contact us with your recommendation at: gimspp@gimspp.org

41. Texas Academy of Internal Medicine And now a word from our sponsors

42. Texas Academy of Internal Medicine Sponsors We are very grateful to those who make this program possible: 1.Texas Academy of Internal Medicine (TAIM), Texas Chapter of the American College of Physicians (ACP) (sponsors the program) 2.Texas Higher Education Coordinating Board (funds the program) 3.The VOLUNTEER preceptors who generously share their time and knowledge with you. We are very grateful to those who make this program possible: 1.Texas Academy of Internal Medicine (TAIM), Texas Chapter of the American College of Physicians (ACP) (sponsors the program) 2.Texas Higher Education Coordinating Board (funds the program) 3.The VOLUNTEER preceptors who generously share their time and knowledge with you.

43. Texas Academy of Internal Medicine For more information about ACP or the Texas Chapter, visit www.acponline.org www.taim.org

44. Texas Academy of Internal Medicine We invite you to join the American College of Physicians and the Texas Chapter of the ACP. ACP is the nation’s largest medical specialty society with more than 115,000 members, including more than 15,000 medical students. For a free membership application and a list of member benefits go to: Registration for chapter annual meetings is FREE to student members. We invite you to join the American College of Physicians and the Texas Chapter of the ACP. ACP is the nation’s largest medical specialty society with more than 115,000 members, including more than 15,000 medical students. For a free membership application and a list of member benefits go to: Registration for chapter annual meetings is FREE to student members. www.acponline.org

45. Texas Academy of Internal Medicine “The student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end.” From the works of Sir William Osler “The student begins with the patient, continues with the patient, and ends his studies with the patient, using books and lectures as tools, as means to an end.” From the works of Sir William Osler

46. Texas Academy of Internal Medicine The staff of the General Internal Medicine Statewide Preceptorship Program wish you a wonderful, exciting, and successful experience. If you have any questions, please call (866) 244-6777, toll free. The staff of the General Internal Medicine Statewide Preceptorship Program wish you a wonderful, exciting, and successful experience. If you have any questions, please call (866) 244-6777, toll free.

47. Texas Academy of Internal Medicine Conclusion of Presentation