Practice in an ambulatory setting does not permit the physician to perform a comprehensive history and physical examination on every patient, especially not on patients seen as return visits. In order to function efficiently in the ambulatory setting, medical students must learn to do a limited examination. For the evaluation of patients known to the practice, we suggest the following format for the student's assessment of the patient:

1. Review the patient's problem list (or review the chart to formulate one) before seeing the patient.
2. Elicit the patient's agenda/chief complaint(s).
3. Do a patient-centered problem-specific medical history.
4. Review of systems relevant to problem list.
5. Limited physical examination to evaluate complaints and problem list.
6. Modify problem list.
7. Formulate a plan of action.
8. Review the patient with the preceptor.
9. Identify and research learning issues.
10. Review learning issues with preceptor (as time permits).