A tale of two exposures: A comparison of two approaches to early clinical exposure

Purpose: Early Clinical Exposure (ECE) programs are an increasingly widespread component of undergraduate medical education. Little systematic research exists on the topic. This report compares the approach and cost/benefits of two parallel ECE programs at the Sackler School of Medicine, Tel Aviv University. Method: The two ECE programs were compared using student questionnaires, faculty questionnaires, focus groups and participant-observations. Results: ECE for American medical students in Israel was based upon a semi-structured mentoring relationship with a hospital-based specialist, in which students were able to practice interviewing skills. ECE for Israeli students emphasized structured exposure to a wide variety of primary care settings and informal patient contact. Both ECEs were supplemented by campus-based small group discussion. Students, preceptors and group leaders in both ECEs all reported very high levels of satisfaction and perceived impact on medical training. Conclusion: There appears to be no "best" way to conduct ECE. The ECE should be tailored to the specific needs and goals of the student population. Further research and international comparison is needed.