Educational and Career Outcomes of an Internal Medicine Preceptorship for First-Year Medical Students

OBJECTIVE: Medical educators have attempted in recent years to provide quality clinical experiences for medical students early in their medical training. We questioned whether participating in a preceptorship in internal medicine (PIM) resulted in better performances on subsequent clinical rotations and increased interest in internal medicine. PARTICIPANTS: Fifty-four students have participated in the PIM to date, with control groups consisting of students who applied for it but were not selected (n = 36), students participating in a preceptorship in family medicine (n = 168), and the remaining students (n = 330). DESIGN: Prospective cohort study. SETTING: University medical center and community practices. INTERVENTION: A 2-month, clinical preceptorship following the first year of medical school. MEASUREMENTS AND MAIN RESULTS: The following outcomes were assessed: scores in the introduction to clinical medicine course; grades in the medical ethics course; scores from the internal medicine clerkship; and choosing a career in internal medicine. In their second year, PIM students scored higher in both semesters of the introduction to clinical medicine course (87% and 86% vs 84% and 84%, p’s < .01) and were more likely to receive honors in ethics (50% vs 29%, p < .01) than non-PIM students. During the internal medicine clerkship, PIM students’ scores were significantly higher on an objective structured clinical examination (79% vs 76%, p = .05), ambulatory clinical evaluations (80% vs 76%, p < .01), and overall clerkship scores (78% vs 75%, p = .03) but not on inpatient clinical evaluations or on the National Board of Medical Examiners Subject Examination. Preceptorship students were more likely to receive honors grades in the medicine clerkship (33% vs 10%, p < .01), and they were more likely to match into internal medicine residencies than control students (54% vs 27%, p < .01). CONCLUSIONS: The PIM course is an intervention, early in students’ careers, which appears to benefit them academically and increase their interest in internal medicine as a career

Whole-brain activity mapping onto a zebrafish brain atlas

In order to localize the neural circuits involved in generating behaviors, it is necessary to assign activity onto anatomical maps of the nervous system. Using brain registration across hundreds of larval zebrafish, we have built an expandable open source atlas containing molecular labels and anatomical region definitions, the Z-Brain. Using this platform and immunohistochemical detection of phosphorylated-Extracellular signal-regulated kinase (ERK/MAPK) as a readout of neural activity, we have developed a system to create and contextualize whole brain maps of stimulus- and behavior-dependent neural activity. This MAP-Mapping (Mitogen Activated Protein kinase – Mapping) assay is technically simple, fast, inexpensive, and data analysis is completely automated. Since MAP-Mapping is performed on fish that are freely swimming, it is applicable to nearly any stimulus or behavior. We demonstrate the utility of our high-throughput approach using hunting/feeding, pharmacological, visual and noxious stimuli. The resultant maps outline hundreds of areas associated with behaviors