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Anyone Else Despise Clerkships?

Discussion in 'Allopathic' started by RadicalRadon, Apr 11, 2012.

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  1. RadicalRadon

    RadicalRadon

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    I'm finishing up my clinical year soon. I've honored all rotations so far, but I have been unbelievably miserable in doing so. I just don't enjoy being in the hospital or doing anything clerical (cough, I mean clinical). I can't stand rounding, admitting patients, standing endlessly in the OR, falling asleep in the reading room, etc.. I really enjoyed my basic science years, but I feel like the clinical year has sucked the soul out of learning. It's so damn boring and you learn so inefficiently on the wards... like you learn some random super specific indication for a drug on a highly sub specialized service. I can learn more by reading for an hour than the random crap that's covered in 7 hours of continuous rounding.

    Anyone else miserable or felt like this? I honestly feel like I have no idea why I'm here. Is it just to collect grades to get a prestigious residency of my choice? Seems that way.
  2. achamess

    achamess

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    Amen.

    I haven't hit quite this level of misery yet, but everything you say is true. The clinical year is terribly inefficient most of the time. The few exceptions have been on the rotations where I've been most autonomous, which were family med and when I work in the ED. Sure, I didn't love working up the 10th diabetic of the day, but at least I got to do it by myself, and not have to round. I go into the room myself, see the patient, talk to them, formulate a diagnosis and plan and then report to the resident/attending. And best of all, I was out by 4-5 pm.

    This thread will quickly turn into a pity party. There are many who feel as you do. But I'm curious to hear some ideas for making the clinical year better. What would the ideal clinical year be like?

    Keep your head up.
  3. justaregularmed

    justaregularmed

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    congrats on lasting this long before becoming bitter and jaded.
  4. Cdg02001

    Cdg02001

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    I found my clinical years to be the most rewarding. I agree that there is a degree of monotony on the wards, but on the average I liked finally feeling that everything I did was towards some end and that there was even something noble in scut work, as I was indirectly helping a patient.

    If you honestly feel that the first two years were better than the second two, I might recommend rads or path (while fully admitting that this is a superficial insight, and that actual pathologists/radiologists may disagree with this characterization).
  5. GuyWhoDoesStuff

    GuyWhoDoesStuff I do stuff

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    For me, the fact that I worked a clinical job for several years (where i was drawing blood and starting IVs) before med school made the novelty of finally being allowed to carry a urine specimen to the lab for your resident slightly less special. I kid (sort of) about that example, but overall I did feel that a lot of very basic clinical things on the ward were not enough to cancel out the overall monotony. That said, M3/M4 were still exciting years for other reasons, like being able to now scientifically apply my M1/M2 knowledge instead of just going through the motions without understanding why I was doing certain blood tests or what have you, or getting to work side by side with classmates I didn't get to know before then bu who turned out to be great people.

    I'm sure to some degree I'm currently viewing things with the rose colored 4th year glasses, and M3 especially can be a trying time. You just have to figure out what it is you hope to learn from the clinical years and try to do the best you can.
  6. bauber

    bauber

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    I hate 3rd year. It has made me hate medical school and the culture of medicine.
  7. QuizzicalApe

    QuizzicalApe

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    Most of my rotations have been pretty great. Surgery was pretty paleolithic in its culture, with plenty of scut and little effective teaching, so I definitely felt like that.

    Medicine is, oddly, the opposite. At my clinical site, there's a very strong drive to protect students from scut, with residents scolding each other if a student seems to be doing something even mildly useless, and interns and senior residents are extremely quick to send us home for the day if there is nothing left to be done.
  8. RadicalRadon

    RadicalRadon

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    This is what could be done to make clerkships enjoyable and helpful. I'm not paying 50k/yr to just help you get through your work for the day with no teaching whatsoever... unfortunately, this is usually how things are. Additionally, the intern/residents get paid 50k while "I'm learning" when I literally transcribe 15 notes (vitals, labs, meds, O/N events) and don't even pre-round or present on a service. It's deplorable.

    There should be an institutional policy against wasting students time and an effort to give them time to learn on their own. No one benefits by keeping a student on service from 5am to 8pm.
  9. johnnydrama

    johnnydrama I'm no Superman

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    I'd disagree on the last part, particularly for your subinternship. I think that students being present for handoffs in the morning and evening and taking close to full responsibility for a few patients is key.

    There are valuable lessons to be learned when it comes to being a functioning member of a medical team.
  10. officedepot

    officedepot

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    .
    Last edited: Apr 12, 2012
  11. officedepot

    officedepot

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  12. Marcus Brody

    Marcus Brody Already has the grail.

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    It's called paying your dues. We're awarded a monopoly on providing healthcare services and medications, obviously there is going to be some work (along with all the money) involved in attaining that kind of power. Residents are dealing with the same exact thing. Hate the game not the players.
  13. Chakrabs

    Chakrabs

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    Interesting. This is a complete opposite to my own feelings. I really struggled through the first two years of med school, and then just absolutely flourished in the clinical years. Yes, there's plenty of bull**** to deal with - paperwork, rounding, surly nurses, uncooperative patients - but guess what, that's what daily life as a physician largely has to deal with. As a resident, you deal with even more of that BS, and so when I was given scut to do, I tried to figure out how to do it efficiently, because it would be my responsibility when I was a resident and I may not have a student around to help me.
  14. ArcGurren

    ArcGurren only one will survive

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    That was exactly my experience for M3 as well.

    OP, I actually felt exactly the opposite - while I enjoyed learning about pathology and pathophys in second year, I like M3 WAY more than M1/M2. There's some element of being tired and I certainly didn't enjoy some of my rotations (particularly surgery, though I really liked the diseases) but when I was having fun, I had a TON of fun.

    As for scut... well, I have a pretty straightforward view on it; if your resident is scutting you out for no reason other than he doesn't want to do it and doesn't bother teaching you in any way or helping you out on the wards, that's wrong. However, if your resident is just asking you to help out with what he/she already has to do and it makes your time more efficient and your day faster, that's another story and I haven't really got an issue with that. The latter seems to happen less often though.
  15. Kadava Reviva

    Kadava Reviva Brutally Honest

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    Just suck it up. No one should feel sorry for you.
    Attendings use residents and we can all use medical clerks, who need to learn all menial tasks and drudgery of medicine. To top it all, you are treated much better than your pedecessors. You cannot become a physician until you've been bored, tired and stinky for a few months.
    Last edited: Apr 11, 2012
  16. RadicalRadon

    RadicalRadon

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    I have definitely sucked it up. I've honored all my core rotations although I still have ob/gyn left... If you (as an attending) had me as a student, you probably would have no idea how miserable I am and how much I hate being there.

    It's too bad that my time on service has pushed me farther away from medicine as opposed to closer to it. I honestly enjoy studying for and taking the shelf more than what I do day to day in the hospital, which is next to nothing. However, I will say being in the OR is dramatically better than being on the medicine floor doing endless rounding and getting scutted out like a b*tch with minimal teaching. I'm now honestly considering options outside of medicine post graduation. A flawless CV from a top five... no idea what that gets you but I figure it might open doors outside of medicine.

    To the other posters, I don't mind talking to patients at all because I think working up a patient from scratch is a valuable learning experience. Unfortunately, that raw work up only happens on medicine. Otherwise, I'm just a proxy by which the overwhelmed intern/resident gets their work done. You can only be so happy to do work for nothing before it gets old.

    Also, I would rather kill myself than become a pathologist.
  17. SteinUmStein

    SteinUmStein

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    What about outpatient medicine? It's a completely different beast than being on the hospital floors.
  18. RadicalRadon

    RadicalRadon

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    That's the purpose of this thread. The problem is I feel like medicine isn't for me anymore... it's been that bad. This is coming from someone who has easily been at the top of their class throughout. I'm pretty sure I'd be an excellent physician but you can only defer happiness for so long before you just lose it. Unfortunately, I'm hitting that point now. LMAO, there's no way I could deal with all the misery that goes into a malignant IM or GS residency.
  19. Kadava Reviva

    Kadava Reviva Brutally Honest

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    This is part of the process. You want to be a physician and you probably knew it would not be a walk in the park. Many students prefer the clerkship years, because they finally get patient exposure and start feeling they are finally learning medicine.
    Last edited: Apr 11, 2012
  20. RadicalRadon

    RadicalRadon

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    I definitely agree that outpatient medicine is where students have by far the most value to the attending as achamess mentioned. Those experiences have been where I've learned the most and been the least miserable. Haha, good point. I think outpatient medicine should be a way bigger component of medical education than it is. I've had less than 6 weeks of it all year.
  21. SteinUmStein

    SteinUmStein

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    It's really unfortunate, my third year will be the same way, overwhelmingly inpatient. It's just too bad because most of the crucial physician shortages are outpatient primary care and we just don't get exposed to it enough. Maybe fourth year set up some outpatient electives to see if it's for you? Worst case scenario you get an easier schedule and some time to breathe. :thumbup:
  22. Chakrabs

    Chakrabs

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    Thats because you're a professional student, and clearly too thin-skinned, arrogant, and self-centered to become a tolerable physician.
  23. Kadava Reviva

    Kadava Reviva Brutally Honest

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    You make it sound like it's a bad thing.
    Always be suspicious of a doctor with excellent bedside manners.
  24. RadicalRadon

    RadicalRadon

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    lol exactly. Bitter much? I bet you hated students like me. Did less work than you, knew more than you, and always scored/were graded better than you. I'm just playing the game like I'm supposed to... putting checkboxes next to grades, step 1, hhmi, etc... that's what medical school has become. That's my point about why it sucks so much.

    Unless you change incentives away from just getting good grades, what else am I supposed to do? Just pass all my clerkships with the maximal amount of work thinking it will "make me a good physician" and set myself up for a lifetime of misery? Sorry, the responsibilities for patient care have shifted upward dramatically. You get your real training in residency. Med school is just a giant resume builder.
  25. SteinUmStein

    SteinUmStein

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    You just described 70-80% of physicians...
  26. Chakrabs

    Chakrabs

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    Cool, have fun in B-school!
  27. Chakrabs

    Chakrabs

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    Oh nice, this is turning into a circle-jerk of bitter med students. I understand that its hard and a pain in the ass right now. But guess what, thats life. Pretty much every job has its share of drudgery and BS involved. Try to appreciate the things you like and move towards doing as much of that as possible. Here, this is a good synopsis of some of the headaches we future physicians are facing but also some of the opportunities.
  28. SteinUmStein

    SteinUmStein

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    I'm not that bitter... yet. :laugh: Physicians are just self-involved, arrogant people in general. Note I said IN GENERAL, there are many docs that are completely humble, selfless people. There are also arrogant, thin-skinned physicians who mean well and are terrific docs for their patients. This isn't just a physician problem, many professionals are arrogant and don't take criticism well... lawyers, many in business, and on and on.

    That's an excellent read by the way, I really like his style of writing/speaking.
    Last edited: Apr 11, 2012
  29. chidoman

    chidoman

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    .
    Last edited: Apr 29, 2012
  30. DeadCactus

    DeadCactus

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    Hard to disagree with this. I have to imagine that medical school is far different now with Medicare/Medicaid spreading the patient load out beyond the teaching hospitals and the medico-legal environment drowning the whole team in more scut and fears of liability.
  31. RadicalRadon

    RadicalRadon

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    B-school seems to be pretty useful based off what this prominent neurosurgeon MD/PhD says... I wouldn't convey it in such a dismissive tone like you do. I guess you're part of that 70-80%, eh?

    http://poetsandquantsforexecs.com/2...om-brain-surgeon-to-an-executive-mba-at-duke/

    So very true. The issue is that right now, it's mostly drudgery. Did you get to bovie much on surgery? lol
  32. Bacchus

    Bacchus PGY-Uh Oh Moderator

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    We don't have it bad. You leave at a decent time. Meanwhile your resident has to stay behind and follow up and sign off on all labs for his patients, complete charts, dictate, fulfill outstanding orders, etc. Woe is me.
  33. RadicalRadon

    RadicalRadon

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    Except often residents make you stay until their sign out, so you leave at the same time. Often med students come in earlier to make all the notes too. Additionally, residents/interns get to go home and rest while we still have to study a ridiculous amount to make up for the lack of learning throughout the day. That is, if you want to actually do well on the shelf or learn anything.

    Obviously this is all dependent on your institution and team, but to say med students uniformly spend less time in the hospital is not really true... and it blatantly ignores that the fact that we have to make up for the lack of learning with studying on our own and less sleep.

    And... normalcy is a made-up word by Prez Harding. The legit word is normality! :p
  34. umean2tellme

    umean2tellme

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    I disliked a lot of rotations, especially ones with where I rotated with classmates who were gunners. When I was the only student around the rotations were great.

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