UConn SOM CLIC Program

Welcome to the UConn SOM! Over your first three years of medical school, you'll spend half a day each week with a community physician preceptor in Primary Care – Internal Medicine, Family Medicine, or Pediatrics. This allows you to apply what you're learning in basic science classes in a real medical practice under physician preceptor supervision. This program uses the acronym "CLIC" and stands for Clinical Longitudinal Immersion in the Community.

To match you with one of our exceptional faculty physician preceptors, please complete the survey below so we can get to know you better. Once completed, our office will arrange either in-person or virtual sessions to meet you, answer any questions you may have about CLIC, and ensure everything is set for your participation. If you have any questions in the meantime, please don't hesitate to ask. We're looking forward to meeting you in a few weeks!

Pleaes complete this survey no later than Friday, July 19th.


Thank you,
Dr. Jaclyn Jaeger, Jenn Foster & Rasy Mar
UConnSOMCLIC@uchc.edu

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* 1. Contact information

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* 2. What town will you be living in during medical school?

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* 3. Are you living with other medical students?

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* 4. Do you have a car?

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* 5. Regarding commuting, do you have family or friends residing in a specific part of the state where you might prefer to be placed? While we cannot guarantee placement in that area, we will make every effort to accommodate your preferences.

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* 6. Please rank your Primary Care discipline preferences below (1 being the highest and 4 being the lowest):

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* 7. How interested are you in pursuing a career in Primary Care?

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* 8. Do you plan on applying to the UST (Urban Service Track)?

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* 9. Do you speak any languages fluently besides English? By fluent, I mean you can comfortably hold a conversation and conduct a medical history in that language.

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* 10. Do you have a specific specialty in mind that you're passionate about? For instance, Cardiovascular Medicine, Pediatric Hematology/Oncology, Sports Medicine, Urology, etc.

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* 11. Please specify if you have a particular career goal in mind as you begin medical school:

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* 12. How would you describe your personality and learning style? For instance, are you introverted or extroverted, and how do you typically learn best?

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* 13. At what pace do you typically prefer to learn?

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* 14. Have you had any previous clinical experience?

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* 15. Have you worked or shadowed with a healthcare organization prior to medical school? If so, please describe your experience.

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* 16. Do you have experience working with children?

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* 17. What are your hobbies, interests, or extracurricular activities? For example, do you enjoy art, music, sports, or any other activities?

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* 18. Is there anything else you would like us to know before we finalize your placement?

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* 19. If you have any questions about the program that you would like us to address during the group session, please feel free to share them here:

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* 20. CLIC Poster - We will design a bio poster detailing the CLIC program, which will be displayed in the waiting room. Please use the text boxes below to provide 3 quick facts about yourself that we can include on the poster for patients to read about you.

Examples may include:
- Home town
- Undergrad School Name
- Clinical interests
- Hobbies/activities
- Fast/fun fact about yourself

Please try to keep it short as we'll need to cut them down to fit on the poster. Thank you!

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