CLINIC rotations connect textbook material with real-world patients

By Lindsay Lyle
lalyle@health.southalabama.edu

Using an otoscope, Jessica Pham, a second-year student at the University of South Alabama College of Medicine, looked into a pediatric patient’s ears.

There was only one problem: she didn’t know what she was supposed to be looking for, exactly.

Her clinical preceptor, pediatrician Matthew Cepeda, M.D., noticed his student’s hesitation. He later sat down and let her look into his own ear while holding up a picture of an eardrum for reference. Once she understood, Pham became more confident at identifying inflamed eardrums – a condition she saw frequently in her pediatrics rotation.

“I loved how Dr. Cepeda took that much time out of his day to teach me,” Pham said.

He also taught her the importance of tracking growth and milestones at well visits and the proper way to use a stethoscope on a child. “The trick is to drop the diaphragm down the shirt and hold it from the outside to listen for heart sounds,” she said.

Cepeda, a 2003 graduate of the USA College of Medicine, is in private practice in Mobile. He gives back to his alma mater by serving as a preceptor in the Clinically Integrated Introductory Course (CLINIC), which provides first- and second-year medical students experiences in career exploration as they rotate through various specialties such as pediatrics.

Cepeda said his role as a preceptor means “slowing down the pace of practice to allow for teaching and preparing students for what life may look like in the future.” This entails priming his staff to operate in a teaching-friendly environment, preparing families to interact with medical students, and reviewing his patients and conditions ahead of time to develop teaching points.

First-year USA medical student Clay Crout described Cepeda as “an exceptional teacher and an even better physician.”

“He helped me understand how important it is to build good rapport and trust with the patient and the family,” Crout said. “Dr. Cepeda would repeatedly stress this, and it was very beneficial to see the ways that he would put it into practice once he entered the exam room."

Crout also made a connection between what he encountered in the clinic and the material he was learning in class. “While in the clinic we saw a patient that gave Dr. Cepeda the opportunity to teach me about croup and RSV," he said. "The very next day we learned about croup in class, and I was able to connect the clinical presentation with the pathological cause.”

Maria McElyea, another first-year USA medical student, said while the clinical skills course and simulated patient encounters provide some opportunities to practice their skills, "those patients do not actually present with any illness. So, these rotations out in the field allow us to actually see the problems we will face once we are practicing out in clinic."

The rotations also fill in some of the gaps in their knowledge and help students develop the soft skills needed to be good physicians, McElyea added.

When Elizabeth Minto, M.D., director of clinical skills at the USA College of Medicine, approached Cepeda with the opportunity to become a CLINIC preceptor, he readily jumped on board for the “fun of having students around to talk to, educate and learn from.” 

According to students who have rotated with Cepeda, the enthusiasm is mutual.

“Dr. Cepeda is an outstanding human being, and I have a lot of admiration for him as a person,” Pham said. “He reminded me of why I wanted to go to medical school in the first place.”

To learn more about CLINIC or becoming a preceptor, contact Candis Patterson at (251) 460-7139 or cpatterson@southalabama.edu, or Elizabeth Minto, M.D., at leminto@health.southalabama.edu.