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Interested in learning more about this rotation? Start the process for a free introductory meeting with our team
Physician ID:
375
Hours:
Patient care: Three days per week, 9 AM to 5 PM (days will vary from week to week – please obtain the schedule for the month from the preceptor)
On the other two days of the week, you will complete topic reviews, reading assignments, and other tasks to enhance your learning from your direct patient care experiences.
Hours have been provided by the preceptor. Hours are subject to change at the preceptor’s discretion, but the minimum total hours will remain approximately the same.
Location: San Francisco
This outpatient US clinical experience will take place in the Bay Area at the preceptor’s office, at different facilities (nursing home, hospice, memory care), and in patients’ homes.
Rotators will meet with the team in the morning at either the practice’s office or other location and then travel to other locations in the team’s vehicle.
Outpatient US Clinical Experience in Family Medicine in San Francisco
Specialties: Family Medicine
Location: San Francisco
Price:
Hospital Letterhead: No
Faculty Appointment: Yes - Georgetown
Information about this clinical experience:
This is an outpatient US clinical experience during which you will be under the supervision of a physician who is board certified in Family Medicine. This preceptor has a deep commitment to improving healthcare in the U.S. and looks for ways to fill existing gaps in the care of vulnerable patients. As this physician is truly an innovator, rotators will have a wonderful opportunity to see how a forward-thinking doctor can change the way in which medicine is practiced.
Frail, vulnerable older adults face many barriers to healthcare access. Accessing healthcare can be difficult for older adults with disability or transportation challenges. One practice model that can be particularly effective in meeting the needs of individuals in this age group is house calls. In the olden days, physician house calls were common. After a significant falloff in the percentage of physicians making house calls, there has been some renewed interest among physicians in bringing care to patients’ homes.
There are numerous benefits to making house calls. Observing the patient in the context of their physical and social environment can be very insightful. Factors that can be difficult to assess in a traditional clinic or outpatient practice, such as social factors, nutrition, hygiene, and compliance with medication, are more readily and easily addressed in the home. Collateral information obtained from caregivers may provide crucial information for making treatment decisions. In addition, as caregiver stress is a significant problem, visiting the family in the home allows the team to offer support to not only the patient but also the caregiver.
As a rotator, you will have the opportunity to visit patients in their homes or participate in telehealth for acute care complaints, chronic disease management, and prevention and risk factor modulation. You will see how the preceptor and the team work tirelessly to meet the varied needs of their patients with a focus on keeping patients out of the hospital. There is a considerable body of evidence that shows high-quality home care can reduce hospital readmission rates, cut down on healthcare costs, and increase patient satisfaction.
You will see how the team utilizes their clinical acumen, careful observation, critical thinking, and creative decision-making to provide excellence in care. Due to the complexity of the patients’ conditions, both medically and socially, you will observe how a multidisciplinary approach is employed to deliver holistic care. One important aspect of care delivered in this practice are goals of care conversations and advance care planning. Through these conversations, the team helps patients understand their healthcare priorities and make important decisions to align future treatment with consideration of their values and preferences. When patients require palliative care, the team is equipped to perform comprehensive assessments of these patients, create care plans, and provide ongoing support to manage symptoms and tend to quality-of-life issues.
To prepare for this clinical experience, we recommend you read the following very informative and enlightening article:
During your experience, you will learn the following U.S. medical practices under the preceptor’s supervision (please note that this experience remains within the regulations of California pertaining to the unlicensed practice of medicine):
Taking patient histories under supervision.
Examining patients under supervision.
Presenting patients.
Entering notes in EMR (Athena)
Having opportunities to research the literature to answer clinical questions at the point of care.
Educating the patient.
Spending time with other healthcare professionals to understand their roles and responsibilities.
Who should consider this rotation:
International medical graduates (IMGs) and students seeking US clinical experience in Family Medicine as house calls are most often conducted by these types of physicians.
How to obtain a letter of recommendation:
The rotator should ask the preceptor for a LOR near the conclusion of the rotation. Dr. Desai has provided the physician with guidelines about best practices in letter writing that meet residency program requirements. In some cases, the preceptor may ask the rotator to write a letter of recommendation draft.
During the rotation:
Our team will be checking in periodically with you to ensure that you are having an optimal experience. We encourage you to contact us if you have any questions during the rotation.
Testimonials
Dr. X was an outstanding preceptor who ensured that I remained actively involved throughout the entire rotation. The doctor encouraged participation at every opportunity, answered all of my questions with patience, clarified my doubts, and shared a remarkable amount of clinical knowledge in a relatively short period of time. Dr. X frequently challenged me with questions during patient encounters, which kept me engaged, helped identify gaps in my knowledge, and motivated me to continuously improve my clinical reasoning.
In addition to Dr. X, I had the privilege of rotating with other doctors and physician assistants. Every member of the team was welcoming, approachable, and genuinely enthusiastic about teaching medical students. Dr. X shared valuable experiences from their clinical careers, discussing memorable patient cases, diagnostic approaches, and practical tips on effective case presentations. These discussions greatly strengthened my understanding of clinical reasoning and reinforced the importance of developing a broad differential diagnosis before arriving at a final diagnosis.
One of the greatest strengths of this rotation was the emphasis on active learning. I was consistently encouraged to obtain patient histories independently and perform physical examinations whenever appropriate. This significantly improved my confidence in history-taking, physical examination skills, patient presentations, and my ability to build rapport with both pediatric patients and their families. I also gained a deeper appreciation for how textbook presentations often differ from real-world clinical practice and how patient management frequently requires individualized decision-making based on each patient's unique
circumstances.
Overall, this rotation has been one of the most valuable clinical learning experiences of my medical training...I am sincerely grateful for the mentorship and support I received throughout this experience, and I would gladly choose to rotate here again if given the opportunity.
SM
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