According to the American Academy of Family Medicine, primary care is defined as follows: “Primary care is that care provided by physicians specifically trained for and skilled in comprehensive first contact and continuing care for persons with any undiagnosed sign, symptom, or health concern (the "undifferentiated" patient) not limited by problem origin (biological, behavioral, or social), organ system, or diagnosis. Primary care includes health promotion, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses in a variety of health care settings (e.g., office, inpatient, critical care, long-term care, home care, day care, etc.). Primary care is performed and managed by a personal physician often collaborating with other health professionals, and utilizing consultation or referral as appropriate.Primary care provides patient advocacy in the health care system to accomplish cost-effective care by coordination of health care services. Primary care promotes effective communication with patients and encourages the role of the patient as a partner in health care.”
Primary care is defined by PCLT to be:
- Family Medicine (adults, children, pregnant women, minor surgery)
- Primary Care Pediatrics (children only)
- General Internal Medicine (adults only)
- Medicine/Pediatrics – primary care (adults and children)
- Obstetrics and Gynecology – general practice
- Pediatric/Psychiatry – general practice
- Medicine/Psychiatry – general practice
- Geriatrics – primary care
Overview of the 4 Years
Year 1
PCLT students participate in a 2 ½ day pre-orientation in late July at Duke prior to the general School of Medicine orientation. This focuses on leadership skills and team-building. Leadership training continues with weekly PCLT team meetings and monthly student-led dinner programs. PCLT students organize a community service project in both fall and spring. They participate in evaluation of their skills. Students complete the rest of the Duke SOM curriculum with students in the traditional MD track.
Year 2
PCLT students participate in a 7-month Longitudinal Integrated Clerkship (LIC) where they learn medicine alongside faculty in their clinics in family medicine, pediatrics, general internal medicine, and gynecology. In addition, PCLT students serve a community agency working on health issues one half day each week during LIC. Students follow pregnant patients through pregnancy and delivery in a Centering model of group prenatal care. They follow patients to surgery, therapy, and specialty visits. They meet weekly in the Primary Care Seminar to share experiences and learn clinical medicine topics. They also have experiences in radiology and anesthesia tailored to the future primary care physician.
PCLT students complete an orientation to the Durham community and learn about community engagement.
There are inpatient immersions in internal medicine, neurology, surgery, psychiatry, and pediatrics. PCLT students attend a Behavioral Health Seminar as well as population health seminars each designed especially for PCLT with primary care in mind. PCLT students attend the Clinical Skills Foundation and Clinical Skills Course with students in the traditional track as well as Cultural Determinants of Health 2.
Year 3
PCLT students develop and implement a population health improvement research project. All projects have a required community or stakeholder engaged component. PCLT has a dedicated director of research to guide students’ research efforts. PCLT students complete a continuity clinic experience. All students have the option of a 10, 11 or 12-month third year. Many of our Duke PCLT students take advantage of dual degree programs or study aways as part of the Duke Medical School Curriculum.
More about Year 3
Examples of PCLT Research Projects
Year 4
PCLT students choose from a variety of clinical electives available to all students. Along with traditional students, they complete a subinternship, critical care training, radiology training, and the Capstone course.