yeah I pretty much hated going in for most of my rotations except when I knew I had an easy day or a really good team that let me leave early. Really the issue is that students have so much more to do beyond going in to clinic/hospital/OR whatever. We have to study, do dumb busy work assignments, worry about crap evals, etc. Also it's the first time we ever really are putting what we studied into practice so that's always tough.
4th year is better for a few reasons:
1. we already know the ropes of pretty much any future rotation we do.
2. by the time you do some rotations residencies won't even see them so the grade matters a lot less.
3. you can actually pick what you want to do for most rotations
When you're an intern/resident that'll be the 3rd year of doing rotations so you're much more comfortable. Also at that point it's a job and you actually have some responsibility so you'll look at work differently and the studying you do will be more focused. The most you have to worry about beyond patient care is not being an idiot in front of the attending and probably getting some research for a fellowship from what I have seen. Beyond that there's no dumb shelf exams, subjective evals for a grade that determines your future, etc.
so things will get better. I hope .
Ohh.. intern year sounds SO much better.
I really don't think 3rd yr is very high yield...
So far, I've spent most of 3rd yr learning how to adapt my "presentation" & SOAP notes to different residents/attendings.
Anyway, I think I'll probably learn more in 1or 2 months of intern yr than the whole of 3rd yr... I say this because I feel like I knew the most at the
start of 3rd yr, fresh off of Step 1. Since then, it's just been a steady decline! What I count as knowledge is that true understanding of pathophys, pharmacology, etc.
That loss of theoretical knowledge has NOT been balanced by new clinical knowledge. I've definitely lost more than I've gained. 'Cuz despite what we're told about how it's not important for us to learn how to do the "mechanics" of placing orders, calling consults... well, I actually learn a lot by learning the mechanics. Like if you prescribe ketorlac, also make sure they're on a PPI. Those little things you might not pick up on unless you're the one placing the order. Until you're forced to do it, no one cares to take the time to answer all your Qs about how to do it, why, etc.
Instead of learning the mechanics, we spend a bunch of time following people around doing nothing ("rounding"), or doing scut... basically, there's a TON of useless/wasted time in 3rd yr.
I think sub-Is are helpful... and maybe the 1st 2 wks of any required rotation, such as peds... but that's about it. I mean, for each major topic such as RSV, give me a lecture on it, let me see 3 or 4 cases of it.. and that should be good, don't you think? If you took all the fluff out of a rotation, it's really only a few days' worth of lecture material, then maybe 2 wks worth of (distinct) clinical exposure. It's really not instructive to do 3 wks of RSV. Nor is it instructive to struggle with a super complex transplant patient before we've even learned how to manage the bread & butter cases. But that's how my 3rd yr has been... loads of down-time, and fairly random exposure. Really inadequate exposure, in some ways.
Does anyone else feel like 3rd yr could be a LOT more condensed ?
I'm a little scared 'cuz I really feel like I've forgotten a lot more than I've learned...