What is a preceptorship?

That was the exact question I was asking myself when I started medical school and even up until my first day at the clinic. There isn’t a very good definition on Wikipedia and it’s definitely not in ye ole trusted Miriam Webster. Even asking older students led to a multitude of definitions ranging from “glorified shadowing” to “being a doctor’s assistant.” Both of which were not entirely satisfying. It wasn’t until I started a couple weeks ago, that I uncovered what a preceptor was: a role model for patient interaction.

It’s difficult to learn how to build a relationship with a patient or deliver bad news purely from reading journal articles and practicing with classmates. Reading evidence-based practices for introducing yourself and shaking hands is helpful, but not the same as doing it with someone you’ve just met. Sitting down and setting an agenda for a fake patient interaction with your friend that you spent all of last night studying metabolism with, is not the same as starting your first conversation with a patient. As much as you pretend to not know each other and create that reality, you can’t help but talk about that one quiz question from last week or your fellow classmate’s birthday dinner tomorrow night. It’s great practice – with your classmates you can feel free to completely mess up, to forget a couple points and try out new questions – but not the same as sitting down with someone who is genuinely sick or in terrible pain and trying to communicate with them. Class gives you the tools to communicate with patients, but preceptorship allows you to watch a professional do what you’ve spent weeks practicing with style and grace.

In my preceptorship, we work with many people who are needing end-of-life care. Most of our patients are very sick and have been sick for a number of years. Many times a patient will already have their diagnosis so our main priority is to provide support during their lengthy treatment. On rare occasion, we need to have a hard conversation starting with “we noticed a suspicious mass on your latest CT scan.” It’s through these few encounters, though, that I’ve learned the most about being an empathetic doctor and have seen human resilience in action. I’ve learned about the power of touch and lending a sympathetic ear to someone who is merely trying to understand their new diagnosis. I’ve seen how speaking the simple statement “I am here for you, we are here for you, you are not alone in this,” can take someone whose outlook on life was utterly hopeless – their shoulders slumped from the weight of endless minutes of data and treatment options, their eyes glued to the floor as if the answer to their problems would be carved into the tile of the exam room, their faces immediately aged 20 years and simultaneously frozen in time, completely and utterly stunned – and completely turn it around. That ability to inspire hope is truly magical. That’s not something that you can learn in a book; it’s something you learn from a role model.

Nothing compares to the first time you step into a patient’s room alone to talk to them, only to mispronounce the word “auscultate” out of sheer nervousness and then bond with them because of it, or the satisfaction of seeing a smile on your preceptor’s face after producing a thorough history. So what is a preceptor? A preceptor is a role model for being an empathetic, caring professional, and I am so grateful to have this opportunity.