Wednesday night at the clinic

As schools around the country rethink medical education and look for ways to enhance clinical experiences for students, the Wednesday Evening Clinic can look back on almost three decades of a unique experiment [“Learning for the Long Run,” Spring 2001]. Since the mid-1970s about 15 students each year have enjoyed a rare opportunity in medical school—the chance to see the same patient over and over again—and learned how to manage long-term clinical care. Working under the supervision of attending physicians, medical students interview patients, conduct physical exams, make diagnoses and recommend treatment.

For G. Morris Dillard, M.D., Ph.D., who founded the clinic, the clinic’s value is not in the information that students acquire, but the ability to think clinically.

“It is the logical reasoning with the material you have at hand that is the most important thing the clinic can accomplish,” he said.

The clinic serves as an example of how to expose students to long-term clinical experiences at a time when the medical school is exploring ways to teach universal, as opposed to discipline-specific, skills. “There is an interest in a longitudinal experience,” said Herbert S. Chase Jr., M.D., deputy dean for education. “To that extent, the Wednesday Evening Clinic was really a pioneer.”

Kathleen P. White, M.D., the clinic’s director, said the clinic has seen a few changes in recent years. Spanish-speaking first- and second-year students are on hand to interpret for patients. Undergraduates interested in medicine provide clerical support. Four more attending physicians have joined the roster of volunteers, and the clinic has recruited community doctors. Clinic files are now computerized so preceptors can review student notes on their cases online.

And this year, said White, two students found long-term preceptorships outside the clinic, in reproductive gynecology and vascular surgery. “They got longitudinal experience in their interests,” White said.