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Teach Learn Med. 2016 Jul-Sep;28(3):329-36. doi: 10.1080/10401334.2016.1152899. Epub 2016 Apr 19.

The Community Preceptor Crisis: Recruiting and Retaining Community-Based Faculty to Teach Medical Students-A Shared Perspective From the Alliance for Clinical Education.

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a Medical Education, Baylor College of Medicine , Houston , Texas , USA.
b Office of Medical Education, University of Nebraska Medical Center , Omaha , Nebraska , USA.
c Department of Psychiatry , Eastern Virginia Medical School , Norfolk , Virginia , USA.
d Department of Obstetrics and Gynecology , Mayo Clinic , Rochester , Minnesota , USA.
e Academic Affairs, Medical College of Georgia Augusta , Augusta , Georgia , USA.
f Departments of Pediatrics and Medicine , Medical University of South Carolina , Charleston , South Carolina , USA.
g Department of Family Medicine and Community Health , Perelman School of Medicine , Philadelphia , Pennsylvania , USA.
h Department of Surgery , Montefiore Medical Center , Bronx , New York , USA.
i Health Informatics, Weill Cornell Graduate School of Medical Sciences , New York , New York , USA.
j Department of Neurology , Weill Cornell Medical College , New York , New York , USA.
k Department of Family Medicine , University of North Carolina , Chapel Hill , North Carolina , USA.



Community-based instruction is invaluable to medical students, as it provides "real-world" opportunities for observing and following patients over time while refining history taking, physical examination, differential diagnosis, and patient management skills. Community-based ambulatory settings can be more conducive to practicing these skills than highly specialized, academically based practice sites. The Association of American Medical Colleges and other national medical education organizations have expressed concern about recruitment and retention of preceptors to provide high-quality educational experiences in community-based practice sites. These concerns stem from constraints imposed by documentation in electronic health records; perceptions that student mentoring is burdensome resulting in decreased clinical productivity; and competition between allopathic, osteopathic, and international medical schools for finite resources for medical student experiences.


In this Alliance for Clinical Education position statement, we provide a consensus summary of representatives from national medical education organizations in 8 specialties that offer clinical clerkships. We describe the current challenges in providing medical students with adequate community-based instruction and propose potential solutions.


Our recommendations are designed to assist clerkship directors and medical school leaders overcome current challenges and ensure high-quality, community-based clinical learning opportunities for all students. They include suggesting ways to orient community clinic sites for students, explaining how students can add value to the preceptor's practice, focusing on educator skills development, recognizing preceptors who excel in their role as educators, and suggesting forms of compensation.


clinical clerkships; community preceptors; medical education

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