The authors describe fundamental changes that have occurred in academic health centers since the 1990s that have caused an increasingly fragmented experience during core clerkships where medical students risk disconnection from faculty mentors, residents, and patients. Longitudinal “continuity” clinical experiences may constitute a strategy for restoring some of the historic learning conditions. In this issue, Myhre and colleagues and Woloschuk and colleagues compare the performance of students who completed a longitudinal integrated clerkship with the performance of their peers who had completed a traditional rotation-based clerkship year and find that the results are comparable in medical school and after the first year of family medicine residency training. In addition, the authors of this commentary offer observations from their own experience with adding continuity options to traditional core clinical clerkships, with the goal of helping readers understand the range of opportunities and challenges that such initiatives entail.
Dr. Stevens is health sciences clinical professor and director of curriculum development, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, California, and director of quality and process improvement, Department of Emergency Medicine, Harbor–UCLA Medical Center, Torrance, California.
Dr. Wilkerson is senior associate dean for medical education, David Geffen School of Medicine, UCLA, Los Angeles, California.
Dr. Uijtdehaage is director of research, Center for Educational Development and Research, David Geffen School of Medicine, UCLA, Los Angeles, California.
Editor’s Note: This is a commentary on Myhre DL, Woloschuk W, Jackson W, McLaughlin K. Academic performance of longitudinal integrated clerkship versus rotation-based clerkship students: a matched-cohort study. Acad Med. 2014;89:292–295; and Woloschuk W, Myhre D, Jackson W, McLaughlin K, Wright B. Comparing the performance in family medicine residencies of graduates from longitudinal integrated clerkships and rotation-based clerkships. Acad Med. 2014;89:296–300.
Funding/Support: None reported.
Other disclosures: None reported.
Ethical approval: Reported as not applicable.
Correspondence should be addressed to Dr. Stevens, Dean’s Office, Center for Educational Development and Research, David Geffen School of Medicine at UCLA, Box 951722, 60-051 CHS, Los Angeles, CA 90095-1722; telephone: (310) 825-6928; e-mail: CarlStevens@mednet.ucla.edu.