Alumni

Alumni News–FCM

Alumni Give Medical Students a First Taste of Medicine

Thanks in large part to our alumni, first- and second- year students in the medical school have the chance to interact with patients as early as their first month on campus -- putting newly gained knowledge to use in a hands-on environment.

Established in 1995, the school’s Foundations of Clinical Medicine program pairs each student with a preceptor in the community for two afternoons a month. In that setting, the basic skills that students have learned in the course - medical interviewing, physical diagnosis, and sound clinical reasoning - truly come to life.

Of the more than 330 preceptors who participate in the FCM course, nearly half are M.D. or housestaff alums of the medical school. One such alum is Dr. Nicolas Tulou, M’75, who signed on about five years ago to bring students into his practice at Internal Medicine Associates of Virginia, where he sees mostly geriatric patients. This year he is paired with Stéphanie Mayer, a second-year student from Lynchburg, Va.

“It’s one of the few things I do that I get a real kick out of,” says Dr. Tulou. “It’s refreshing to have someone ask a different question or offer a different perspective. By its very nature, the interaction is stimulating.”

Dr. Tulou recalls his own days as a medical student, when physical diagnosis was covered in the classroom and quick trips over to the inpatient wards provided hands-on learning. Though there were opportunities for elective work in the community, for the most part, “students were flying by the seat of their pants in years three and four.” He believes that, today, the FCM program provides more opportunities for necessary feedback.

In her first year in the FCM program, Stéphanie was paired with Richmond-area pediatrician Dr. Tim O’Neil, M’90/H’94. There she was able to master the basics of the physical exam. So now, Dr. Tulou says that he tries to “give her more of a chance to process, describe and attribute significance to what she hears from the patients. Then we together generate a list of what needs to be addressed for each patient.”

She appreciates that Dr. Tulou correlates aspects of the topics she’s been studying in her FCM small group with patient cases they see in his office or when they visit his patients in the hospital.

Stéphanie vividly recalls a class discussion of situations in which to prescribe diuretics. That very day in her preceptorship, “I met a patient who presented with nearly the exact history that had been discussed in class but for whom we realized that the use of diuretics was in fact worsening the gout which affected his knee.”

While Stéphanie wonders if it is ever possible to feel thoroughly prepared for third-year rotations, which simultaneously thrill and intimidate second-year students, she credits her FCM experiences with diminishing “at least some of the feelings of being less than completely prepared when faced with patients.”

On those afternoons when he has a student with him, Dr. Tulou books fewer patients and builds additional time into his schedule for the questions and discussions that characterize the preceptorship experience. He’s found that his patients like dealing with the students and are tolerant of the extra time needed.

For her part, Stéphanie says, “When I treat patients myself, I truly hope to be able to echo the empathy and meticulous care with which Dr. Tulou treats each patient. Going to my preceptorship is a joy - I anticipate it all week.”

The FCM program is always interested in hearing from physicians who would like to learn more about the possibility of becoming a preceptor. Currently, preceptors are physicians who practice Internal Medicine, Pediatrics or Family Medicine within a 75-mile radius of Richmond, providing students exposure to rural, suburban and urban practice settings. For more information, please contact the Foundations of Clinical Medicine office at 804-828-6791 or Course Director Rita Willett, M.D., at 804-828-5323 or [E-mail]: rwillett@hsc.vcu.edu.