Precepting

Precepting Patients: The Who, When and How

The following patients should always be precepted at the time you are seeing the patient, regardless of year of training.  Please check the patient’s insurance prior to ending the visit to ensure Medicare patients are not missed:

• OB visits

• Medicare patients

• Anybody you are considering admitting or sending to the ED

• TCM visits

Special Circumstances:

• All Medicare Patients for whom you are NOT billing a 99213 (including procedures, OMT, etc.) need to be physically seen by your attending prior to leaving the office.

By class:

• R1s:

  • Precept all patients throughout the entire year.  Attendings are required to personally see every patient for the first 6 months of training and will still see patients personally with the resident after 6 months as needed.

• R2s and R3s:

  • Sometimes it’s hard to know how much to precept as you move into 2nd and 3rd year (though most faculty prefer more than less).   It’s generally recommended 2nd years at the beginning of the year precept approximately 75% of their patients with a goal of moving towards 50% at the beginning of 3rd year and 25% by completion of residency.  Though the last month of residency it seems most 3rd years precept about 100% of their patients.  

  • These are just guidelines and it sometimes depends on the day how much precepting is needed, especially as you advance further into your second and third years. Know that your attendings like to teach and you only have 3 years of learning here in the residency (it does go by fast) so feel free to precept as many patients as you would like during 2nd and 3rd year.

  • A few tactics to consider in your R2 and R3 years on busy clinic days:

    • Consider keeping track of your clinical questions that come up on patients you don’t feel a need to precept at the time of the visit. You can run these questions by your attending at the end of the half day to get their take on your decision making. This can be a good way to learn some pearls from your attending and might give you insight into different ways to manage some more common conditions.

    • Consider precepting by giving a short one-liner on more straightforward patients and then asking your most pressing one clinical question. This can focus the precepting session on busy clinic days.

    • Always know that you can make your preceptor aware of your time constraints and asking for them to shorten the precepting session if you’re running behind. This can help a lot on busy clinic days. We all know how busy clinic can get and we want to help however we can. 

    • Also know that you can ask your preceptors for help at any time with general clinic workflow questions. We are here to help and if we don’t know the answer we can almost always find someone who does.

OB Precepting:

See Precepting checklist or OB Expectations for more information.

Updated May 2022