Family Medicine Preceptorship

Placement Questionnaire

Name and contact information:

Please answer the following:

Missouri Residents:

If you’re placed at a preceptor site that requires a universal drug screening you will be required to obtain and pay for one.

Five of the six medical schools in Missouri require a rural rotation. This means there is considerable competition for both preceptors and housing. Students are welcome to submit their preferences with the understanding that there is no guarantee that the physician or location will be available. All placements are based on availability of preceptors and housing. We face a continued shortage of preceptor sites, therefore listing additional housing locations gives you a higher chance of placement during your block and avoids delaying preceptor, which may result in extensive schedule changes.

Please enter all locations in Missouri where you have available housing.

Please note: Potential weather conditions during the scheduled month of Preceptorship will be given serious consideration when assigning a location.

EXCUSED ABSENCES

As stated in the placement and course policy document, a maximum of two days absence will be allowed by the department –any other absence requests submitted to other departments [even if approved], will not be considered. Students must submit a formal clerkship absence excuse form at least four weeks before the start of Preceptorship.  Absence requests are approved by the course director not the preceptor.

Note: Orientation and Wrap-Up sessions are mandatory; absence requests for these days will not be approved.

Please do not contact any Preceptor Physicians – all placements are set up by the clerkship coordinator and/or the clerkship director.

After reading the Family Med II Preceptorship Placement Policies document, please note any other concern you would like taken into account during the placement process.  If you inadvertently omit a concern, please notify Emily Wade at WadeEG@umkc.edu.