Clinical Studies- PISCES Third Year Medical Student Clerkship

"We appreciated the quickness in which our PISCES student returned our calls and his willingness to assist us in whatever way possible.  He has a gift for explaining things in an easy to understand manner.  I have no doubt that he will make an excellent doctor based on this and his exceptional “bedside manner.”  Any patient would be lucky to have him for their doctor. I hope that the PISCES Program continues so that others can have the positive experience that we did."- former PISCES patient

2008-09 PISCES students

The Parnassus Integrated Student Clinical Experiences (PISCES) is an innovative clinical training program for third-year medical students at the UCSF Medical Center that partners students with patients and faculty longitudinally over a year.  PISCES was created in response to concerns that our students are experiencing the loss of ownership over patient care as they are learning to practice medicine in an increasingly fragmented care system.

 Our mission is:
“To educate medical students to practice medicine in a new world that includes evolving healthcare delivery systems, demographic shifts, patient-centered illness models, new health information systems, and changes in graduate medical education.”

 The emphasis of our program is on: 

·         Longitudinal relationships between patients, students, teachers, and healthcare systems

·         The course of chronic illness and a patient’s experience of disease as well as the maintenance of wellness,

·         Development of clinical reasoning skills through early introduction to patients with undiagnosed illness,

·         General skills and integrated knowledge needed for compassionate, effective patient-centered care.

Students build panel of patients that they meet through primary care and specialty clinic and in the emergency room and follow their patients into multiple settings such as clinics, labor and delivery, the hospital and the operating room.  The special relationship that the students form with patients over the year enables the students to enhance patient care by providing support and communicating with the patient and their physician about the patient’s medical issues.  Our students also help their patients navigate an increasingly complex medical system.  In turn, patients help teach our students how to become doctors by enabling them to participate in their medical care. 

Two examples:

Student Doctor A meets Mrs. X in the obstetrics clinic during her prenatal visit.  Student A participates in additional prenatal clinics, answer phone calls from the patient with back up from the obstetrician, and joins the patient in Labor and Delivery to help with the delivery.  After Healthy Baby Boy X is born, Student A adds him to her patient panel.  Student A then see Mrs. X in her post-natal appointments and again in the pediatrics clinic, when she brings her baby for a well-baby check.

Student Doctor B meets Mr. Y in the emergency department where he is taking overnight call.  Mr. Y is admitted with a gallbladder infection.  Student B cares for him in the Emergency Department and later during his stay in the hospital, Student B helps to coordinate care with the team of doctors caring for Mr. Y in the hospital.  Student B is present for tests done in the hospital on Mr. Y’s gallbladder and later attends his gallbladder surgery, helping both pre-operatively and post-operatively.  Student B visits Mr. Y at home after his hospital stay and attends his clinic visits with the surgeon.

Our students work closely with individual faculty from Internal Medicine, Family and Community Medicine, Pediatrics, Psychiatry, Neurology, Surgery and Obstetrics and Gynecology in parallel over the year.  These mentoring relationships fosters the development of core skills and supports the professional development of the student.  The longitudinal relationships with faculty, patients, peers and a single medical system is designed to train patient-centered, adept physician. 

We are proud of the graduates of our PISCES Program and believe we are fostering a new generation of physicians.  We encourage you to learn more about our program by exploring this website.  Please feel free to contact us with any questions about the program.  If you are interested in generously supporting the PISCES Clerkship, please see the link “Giving” below.

PISCES Informational Powerpoint

Description for Patients

Examples of PISCES student projects:

PISCES Newsletters:
December 2008

PISCES photos:
PISCES 2007-08
PISCES 2007-08 Student Roster
PISCES 2007-08 with Faculty
PISCES 2008-09
PISCES 2008-09 Student Roster
PISCES 2009-2010 Student Roster

PISCES Patient Comments