Ask a 3rd Year Medical Student Anything

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sinombre

sinombre

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I'm not sure whether or not this will be useful, but I'll have some down time over the next week so I figured I would try and contribute to SDN for the first time in a long time. I lurked these forums quite a bit before making an account and thought the AMA threads I read back then were pretty helpful/interesting. So ask away.
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Thanks for this! It's very helpful to clueless pre-meds like us :)

Question: How true are all those warnings about third year being the darkest year of med school? Is it possible to have a social life?
 
sinombre said:
I'm not sure whether or not this will be useful, but I'll have some down time over the next week so I figured I would try and contribute to SDN for the first time in a long time. I lurked these forums quite a bit before making an account and thought the AMA threads I read back then were pretty helpful/interesting. So ask away.
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Hey bro! It has been a while since I have seen you around here, Opie. Still lifting?

Let me think of some questions.
 
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700003 said:
Thanks for this! It's very helpful to clueless pre-meds like us :)

Question: How true are all those warnings about third year being the darkest year of med school? Is it possible to have a social life?
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The hours can be very intense, depending on the rotation. I'm on surgery right now, which is probably the worst. I am engaged/planning on getting married at the end of 3rd year/beginning of 4th year, and don't have much of a social life outside of the hospital. But, I absolutely love it. I'm planning on going into gen surg, so although I'm spending a lot of hours in the hospital, it's been an extremely interesting/rewarding experience so far.

Personally I think 3rd year is 10 times better than the first two. I mean the first two years were ok, but nothing beats actually seeing patients and doing things, even if I am at the bottom of the medical hierarchy as a 3rd year.
 
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The Buff OP said:
Hey bro! It has been a while since I have seen you around here, Opie. Still lifting?

Let me think of some questions.
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I haven't lifted much 3rd year at all, but I did have a nice squat session for the first time in a long time tonight. I'm still interested in powerlifting and will probably still do a meet during 4th year.
 
How did you get interested in GS, and what else did you consider?
Do you plan to do a fellowship?

Tips for honoring rotations?
 
karayaa said:
How did you get interested in GS, and what else did you consider?
Do you plan to do a fellowship?

Tips for honoring rotations?
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I've always been interested in surgery/procedures. I like working with my hands, and like the idea of being able to identify a problem and then fix it. I love anatomy. And I love being in the OR. But, I've been interested in just about everything else as well. The intellectual stimulation in medicine is pretty great, and I actually don't mind rounding for hours (as long as I'm actively learning along the way), which is a common thing people who go into surgery seem to complain about with medicine. But I enjoy being in the OR more than anything else, which is kind of the deciding factor at this point.

I have no idea whether or not I will want to do a fellowship. But one of the things I like about gen surg is that there are so many fellowship opportunities.

As for honoring rotations--I don't think I can be much help here, as I just started 3rd year in June. I'm not sure I can really provide any insight that isn't intuitive (always be early, be professional, work hard, get along with the team, work hard, show initiative, work hard, etc). Maybe others farther along in the process will be able to chime in here.
 
sinombre said:
I've always been interested in surgery/procedures. I like working with my hands, and like the idea of being able to identify a problem and then fix it. I love anatomy. And I love being in the OR. But, I've been interested in just about everything else as well. The intellectual stimulation in medicine is pretty great, and I actually don't mind rounding for hours (as long as I'm actively learning along the way), which is a common thing people who go into surgery seem to complain about with medicine. But I enjoy being in the OR more than anything else, which is kind of the deciding factor at this point.

I have no idea whether or not I will want to do a fellowship. But one of the things I like about gen surg is that there are so many fellowship opportunities.

As for honoring rotations--I don't think I can be much help here, as I just started 3rd year in June. I'm not sure I can really provide any insight that isn't intuitive (always be early, be professional, work hard, get along with the team, work hard, show initiative, work hard, etc). Maybe others farther along in the process will be able to chime in here.
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What I really want to know is if you're at a facility that has robot assisted surgery (da Vinci robot) and what your experiences with it are. (Obscure question I know and I'm well aware you can't actually use it on a patient.... Yet, if you've been a part of a surgery in both methods you must have some stories/view?)

To me the robot sounds amazing but the lack of feel sounds terrifying. While it's not pertinent to me at the moment, I'd enjoy reading anything on it from a med students' perspective.
 
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Spirit of the Student Doc said:
What I really want to know is if you're at a facility that has robot assisted surgery (da Vinci robot) and what your experiences with it are. (Obscure question I know....)
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I'm at a facility that only employs surgeon robots. Like the surgeons are actually autonomous machines. I'm curious as to how long it'll take before they decide to rise up and take over. (kidding)

I have 0 experience with robot assisted surgery. I'm still working on getting my suturing technique down, so I don't think exposure to that matters much as a 3rd year, when the entire point of the year is to learn the basics/bread and butter of everything.

But if I do get any Da Vinci exposure this year I'll make sure to try and make this happen:

Da_Vinci.jpg
 
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Spirit of the Student Doc said:
What I really want to know is if you're at a facility that has robot assisted surgery (da Vinci robot) and what your experiences with it are. (Obscure question I know and I'm well aware you can't actually use it on a patient.... Yet, if you've been a part of a surgery in both methods you must have some stories/view?)

To me the robot sounds amazing but the lack of feel sounds terrifying. While it's not pertinent to me at the moment, I'd enjoy reading anything on it from a med students' perspective.
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There's a big learning curve and if you don't keep up your skills you will lose them fairly quickly. The machine itself leads to longer operation times as well as issues with moving multiple arms and positioning. Patients do get out of the hospital faster though. I don't think it's worth it. Then again it is pretty cool to look at a screen and see a 3d picture of the anatomy without a residents arm in the way
 
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Psai said:
There's a big learning curve and if you don't keep up your skills you will lose them fairly quickly. The machine itself leads to longer operation times as well as issues with moving multiple arms and positioning. Patients do get out of the hospital faster though. I don't think it's worth it. Then again it is pretty cool to look at a screen and see a 3d picture of the anatomy without a residents arm in the way
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A surgical oncologist once told me that the robot is freaking overkill in a lot of cases. But I'm sure it makes for excellent advertising.
 
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Psai said:
There's a big learning curve and if you don't keep up your skills you will lose them fairly quickly. The machine itself leads to longer operation times as well as issues with moving multiple arms and positioning. Patients do get out of the hospital faster though. I don't think it's worth it. Then again it is pretty cool to look at a screen and see a 3d picture of the anatomy without a residents arm in the way
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Now, what of the smaller scars and supposed better technique (that can only be done by a machine holding perfectly still) that leads to as you stated getting out of the hospital faster and I'm assuming less prone to error. Or are we talking of a minute difference in most cases?
 
sinombre said:
I'm at a facility that only employs surgeon robots. Like the surgeons are actually autonomous machines. I'm curious as to how long it'll take before they decide to rise up and take over. (kidding)

I have 0 experience with robot assisted surgery. I'm still working on getting my suturing technique down, so I don't think exposure to that matters much as a 3rd year, when the entire point of the year is to learn the basics/bread and butter of everything.

But if I do get any Da Vinci exposure this year I'll make sure to try and make this happen:

Da_Vinci.jpg
Click to expand...
Did a mini-research on this back in the undergraduate and got to interview a top facility. Apparently, the sharp learning curve with new technology and accompanying protocol is sort of ridiculous in my opinion. While compared to laproscopy, you have smaller punctures, the results aren't that significant aside from early patient departure from hospital. I asked a resident about how he felt about the change and how competent he felt on this, he thought that I pointed out an interesting question because clearly we are humans that are being taught at the speed of a computer dealing with a human life with all this tech. In my opinion the Da Vinci has been there for a while now but has a lot more to improve on to make it a significant tool. I feel like top facilities particularly just buy these things to make them look posh and progressive and apparently patients usually buy into these advertisements without knowing truly how effective these so-called robots are.
 
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Are rotations done only at the University's hospital or do people go to other places?

I know people do rotations in places they like to get residencies but is that a rare opportunity or something you can do regularly.
 
MangoPotato said:
Are rotations done only at the University's hospital or do people go to other places?

I know people do rotations in places they like to get residencies but is that a rare opportunity or something you can do regularly.
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Just about every school does 3rd year at hospitals affiliated with the school. 4th year is mostly electives (where people can choose to do aways/sub-I's), with random required things later on. I do get a 6 week elective at the end of 3rd year where I can choose to go somewhere else, but I'm planning on doing gen surg at my home program.
 
Do you have any regrets from premed? I.e. wish you spent more time with friends? or more time working a job to save? etc.
 
SusanGMaxwell said:
Do you have any regrets from premed? I.e. wish you spent more time with friends? or more time working a job to save? etc.
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Nope, no regrets at all. I have a semi-unique background (I think), in that I had no idea I wanted to do anything academic in high school. So I probably graduated high school with around a 2.0 gpa. I went to community college mostly out of curiosity, and realized how much I liked science. I ended up doing well and transferred to a good state school. That's where I decided I wanted to apply to medical school, so I wasn't a "pre-med" before that point. I was there for 3 years and had an awesome time. I majored in philosophy and minored in something more sciencey (so I could knock out a bunch of the pre-reqs), and then worked in clinical research at the med school there for a couple of years.

Undergrad was a great experience for me. I did study quite a bit, but I learned how to manage my time well and did tons of things outside of school (including meeting my fiancee in my last year of undergrad).
 
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sinombre said:
I'm at a facility that only employs surgeon robots. Like the surgeons are actually autonomous machines. I'm curious as to how long it'll take before they decide to rise up and take over. (kidding)

I have 0 experience with robot assisted surgery. I'm still working on getting my suturing technique down, so I don't think exposure to that matters much as a 3rd year, when the entire point of the year is to learn the basics/bread and butter of everything.

But if I do get any Da Vinci exposure this year I'll make sure to try and make this happen:

Da_Vinci.jpg
Click to expand...

Those people, room and robots look vaguely familiar ;)
 
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You doing any aways? We are getting our first bunch next Monday, pretty excited about it, somehow two residents got their vacations scheduled on the same month on our service, so we are going to be light on residents. So... We added the MS4s to the resident call schedule as 'extra residents'. They'll never be alone, but they will get a lot more autonomy than normal. Hopefully they get a really good experience *fingers crossed*
 
mimelim said:
You doing any aways? We are getting our first bunch next Monday, pretty excited about it, somehow two residents got their vacations scheduled on the same month on our service, so we are going to be light on residents. So... We added the MS4s to the resident call schedule as 'extra residents'. They'll never be alone, but they will get a lot more autonomy than normal. Hopefully they get a really good experience *fingers crossed*
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Sounds like an awesome experience
 
Did you ever worry about your philosophy degree in case you didn't get into medical school?

How much were you able to go out the first two years of medical school? How about so far this year?
 
SouthernSurgeon said:
Davinci incisions are actually bigger than most laparoscopic incisions. Davinci ports are 8mm and most lap ports are 5mm (usually use a combo of 5mm ports and 1 or 2 larger 10-12mm ports that allow you to put specialized larger instruments through).

Davinci also nearly universally means more incisions than conventional laparoscopy (camera port, 3 robotic arm ports, plus usually about 2 conventional laparoscopic ports for the assistant to use).

Bottom line for majority of cases in general surgery it offers little advantage to conventional laparoscopy and adds expense and OR time. For some specialized cases the additional dexterity and roticulation you gain from the robot may add some benefit, but research studies have not really supported this on any measurable scale.
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But I'm sure the psychological benefit to the patient of feeling like they're being operated on with some kind of super-futuristic technology is priceless.
 
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Where do you stand on the Kinsey scale?
 
Did you break 250 on step? Have you gunned down any class mates yet?
 
How many licks would it take to get to the center of a Tootsie Pop?
 
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SouthernSurgeon said:
Davinci incisions are actually bigger than most laparoscopic incisions. Davinci ports are 8mm and most lap ports are 5mm (usually use a combo of 5mm ports and 1 or 2 larger 10-12mm ports that allow you to put specialized larger instruments through).

Davinci also nearly universally means more incisions than conventional laparoscopy (camera port, 3 robotic arm ports, plus usually about 2 conventional laparoscopic ports for the assistant to use).

Bottom line for majority of cases in general surgery it offers little advantage to conventional laparoscopy and adds expense and OR time. For some specialized cases the additional dexterity and roticulation you gain from the robot may add some benefit, but research studies have not really supported this on any measurable scale.
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Say you're a surgeon who's employed at a hospital that advertises the robot. Would you be pressured to use it even if it's not necessary?
 
SouthernSurgeon said:
Davinci incisions are actually bigger than most laparoscopic incisions. Davinci ports are 8mm and most lap ports are 5mm (usually use a combo of 5mm ports and 1 or 2 larger 10-12mm ports that allow you to put specialized larger instruments through).

Davinci also nearly universally means more incisions than conventional laparoscopy (camera port, 3 robotic arm ports, plus usually about 2 conventional laparoscopic ports for the assistant to use).

Bottom line for majority of cases in general surgery it offers little advantage to conventional laparoscopy and adds expense and OR time. For some specialized cases the additional dexterity and roticulation you gain from the robot may add some benefit, but research studies have not really supported this on any measurable scale.
Click to expand...

I can't remember the last time we didn't use 3mm ports, but then again we use laprascopes maybe twice a month.
 
sinombre said:
I'm not sure whether or not this will be useful, but I'll have some down time over the next week so I figured I would try and contribute to SDN for the first time in a long time. I lurked these forums quite a bit before making an account and thought the AMA threads I read back then were pretty helpful/interesting. So ask away.
Click to expand...
Hey opie, how do you control getting nervous when communicating with doctors trying to give them an articulate answers and also talking to patients. You can understand how nervous one might be talking to strangers. Thats my biggest problem.
 
SouthernSurgeon said:
Davinci incisions are actually bigger than most laparoscopic incisions. Davinci ports are 8mm and most lap ports are 5mm (usually use a combo of 5mm ports and 1 or 2 larger 10-12mm ports that allow you to put specialized larger instruments through).

Davinci also nearly universally means more incisions than conventional laparoscopy (camera port, 3 robotic arm ports, plus usually about 2 conventional laparoscopic ports for the assistant to use).

Bottom line for majority of cases in general surgery it offers little advantage to conventional laparoscopy and adds expense and OR time. For some specialized cases the additional dexterity and roticulation you gain from the robot may add some benefit, but research studies have not really supported this on any measurable scale.
Click to expand...
that's interesting because what I was referring to was procedures where you have to cut wider punctures. With the robotic arms you can cut small punctures but spread around the body so as not to have a big incision. I grasp what you are saying though and did find the same disappointment with the product.
 
mimelim said:
You doing any aways? We are getting our first bunch next Monday, pretty excited about it, somehow two residents got their vacations scheduled on the same month on our service, so we are going to be light on residents. So... We added the MS4s to the resident call schedule as 'extra residents'. They'll never be alone, but they will get a lot more autonomy than normal. Hopefully they get a really good experience *fingers crossed*
Click to expand...

Yep, I definitely plan on it. Although I think I have a decent amount of time before I figure out where. Sounds like the 4th years at your program have a pretty awesome opportunity!
 
numbersloth said:
Did you ever worry about your philosophy degree in case you didn't get into medical school?

How much were you able to go out the first two years of medical school? How about so far this year?
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You know, I probably should have. But I was so determined to get in that it never really crossed my mind that not getting in was a possibility. I think I assumed that if I didn't get in I would do everything I could to get in the following cycle. Luckily things worked out for me and I was able to get into med school in a location I wanted.

The first two years I had a ton of time. It really isn't that different from undergrad once you adjust and develop the necessary time management skills. I don't really "go out" much, but I had a lot of time for hobbies (I lifted weights almost every day, I took a few weekend camping trips, went snowboarding a handful of times, etc). This year I haven't done much, mostly because it's a pretty big adjustment. If I really wanted to I could probably go out once a week... we always have at least 1 day off per week. But time off really depends on the rotation, and even within certain rotations there's a decent amount of variation.
 
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OSUkid said:
Hey opie, how do you control getting nervous when communicating with doctors trying to give them an articulate answers and also talking to patients. You can understand how nervous one might be talking to strangers. Thats my biggest problem.
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I'm not sure I can be of much help here, I don't typically get nervous about that kind of thing. I feel pretty at ease presenting to residents/attendings, mostly because I am aware of my own status and limitations, and understand that making mistakes is an inherent part of being a 3rd year (and I guess arguably a physician as well). I make a point of learning from everything I don't know/every mistake I make. I think it's perfectly acceptable to not know something when being pimped/questioned by an attending, but I don't think there's an excuse to not know something twice. I keep a notebook in my white coat of things that I don't know the answer to, and make a point of looking them up when I get home every night or in my down time at the hospital.

That said, I think it's very normal to be nervous. The key is probably just exposure therapy. You'll have to do it so much that it'll become second nature in no time at all.
 
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Mad Jack said:
Is third year as bad as you thought it would be?
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It's awesome man. My life is much more enjoyable now. But you had a lot of experience working in a hospital before med school, so you probably have a good idea of what's coming.

The hours are about as long I guess. But most of the time I get pretty caught up in what I'm doing, and by the time I look at my watch I've already been there 12 hours. The hardest part at first was not having time to eat, so I keep a stash of granola bars in my white coat which has worked out pretty well on busy days so far.
 
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sinombre said:
Aren't you sad I didn't end up going to med school in Philly? Because I was pretty close. We could have been drinking buddies and had Saturday night Cards Against Humanity sessions and everything.
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Why drinking? Its always about drinking.
 
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