Helpful 4th year courses

[alreadylernd]

Quick question, I'm planning my 4th year schedule and I want the second half of the year to be full of consult rotations that still will be useful for EM. I mean, I'll have severe senioritis by then, but I might as well be learning something. I'm thinking about taking an ID consult, pulm consult and then an anesthesia month (to hopefully get experience with intubations). Any advice? Cards>Pulm? nephro? Ophtho or Derm? (since you never learn anything about the eye or skin in medical school). How would you prioritize, seeing that there are like only 3-4 blocks. Thanks for the help!

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[12R34Y]

Quick question, I'm planning my 4th year schedule and I want the second half of the year to be full of consult rotations that still will be useful for EM. I mean, I'll have severe senioritis by then, but I might as well be learning something. I'm thinking about taking an ID consult, pulm consult and then an anesthesia month (to hopefully get experience with intubations). Any advice? Cards>Pulm? nephro? Ophtho or Derm? (since you never learn anything about the eye or skin in medical school). How would you prioritize, seeing that there are like only 3-4 blocks. Thanks for the help!

I thought cardiology was AWESOME! Reading 12-leads everyday with attending cardio guys rocks. you learn a ton. You also learn a ton about CHF, AMI, echo's, cool cardio drugs. very useful.

anesthesia is generally a laid back month and you get to tube a bunch of people (always nice to know going into intern year), however most EM programs will give you a month of anesthesia where you'll master the airway. Still useful and fun.

radiology can be very good as well. CXR's, head CT's, and ortho films will be very very very common in all ED's forever. Nice to read them with radiology folks.

you almost can't go wrong with picking something. they are almost always applicable to EM in some way.

Oh, and make sure you do a ICU month. probably the best month of my whole medical career. Art lines, central lines, chest tubes, intubating, sepsis, pressors, anaphylaxis, electrolytes, vents ........you name it. Learned a ton!

good luck,

 

[Koko]

ICU at the top of the list, at least for me. Hi yield in many ways as 12r34y has already alluded to. Have fun!

 

[BKN]

Quick question, I'm planning my 4th year schedule and I want the second half of the year to be full of consult rotations that still will be useful for EM. I mean, I'll have severe senioritis by then, but I might as well be learning something. I'm thinking about taking an ID consult, pulm consult and then an anesthesia month (to hopefully get experience with intubations). Any advice? Cards>Pulm? nephro? Ophtho or Derm? (since you never learn anything about the eye or skin in medical school). How would you prioritize, seeing that there are like only 3-4 blocks. Thanks for the help!

Your residency is going to give you whatever you will need. Plus there almost are no specialties that won't contribute to an EM knowledge base. Why not do something that you wouldn't get otherwise and might be fun to learn, regardless of utility?

 

[Squad51]

Quick question, I'm planning my 4th year schedule and I want the second half of the year to be full of consult rotations that still will be useful for EM. I mean, I'll have severe senioritis by then, but I might as well be learning something. I'm thinking about taking an ID consult, pulm consult and then an anesthesia month (to hopefully get experience with intubations). Any advice? Cards>Pulm? nephro? Ophtho or Derm? (since you never learn anything about the eye or skin in medical school). How would you prioritize, seeing that there are like only 3-4 blocks. Thanks for the help!

I'm doing retinal surgery (seriously!) for two weeks because they will let you fundoscope and slit lamp everybody they see. I've got to imagine the slit lamp thing is hard to pick up in residency and fundosocpy is really a cheap easy way to get at alot of pathology in the ED.

 

[trkd]

ICU at the top of the list, at least for me. Hi yield in many ways as 12r34y has already alluded to. Have fun!

See, this is my dilemma. I hear this business about ICU being a must and it is scaring me. We don't have an ICU experience that is very intense here so I have pretty much not done any ICU. I have an elective that I am deciding what to fill with but was thinking more along the lines of cardiology or something. Now this ICU thing is creeping up on me again. An absolute must to have one month of it before graduating? The idea scares me. It is the 2nd to last rotation for me and it doesn't sound fun from what I hear on the forums. Can't I do what BKN suggested and act like there is no such thing as an ICU???

So ICU a must before graduating??? Please say it is not so. BKN... comfort me, say it isn't so!!!

 

[trkd]

Your residency is going to give you whatever you will need. Plus there almost are no specialties that won't contribute to an EM knowledge base. Why not do something that you wouldn't get otherwise and might be fun to learn, regardless of utility?

Oh yeah, and I got the fun thing checked off. I have 6 months off until I start residency so after interviewing... a month at a hospital in South Africa, a few weeks of appreciating the beauty of the Big 5 on the game reserves, say hi to the family in Turkey, and 2-3 months of working in a rural central american clinic to learn medicine with hands/eyes/ears instead of technology. Zen .

 

[missdr]

i did optho rads and derm and of course the surgical icu which was an awesome learning experience...do not underestimate how burned out you will be by the end of the year and try to schedule more time consuming rotations earlier on before your mind turns to mush like mine right about now (7 days and counting!!!!) if you haven't done any intubations i would recommmend anesth since you will just be so much more confident about tubing patients as an intern if you have had your hands on the blade a few times ( i did mine 3rd year) just make sure you take all the vacation you can get so you are well rested for internship!!!!

 

[bluejay68]

As an EM intern, my MICU and PICU months were two of the highest yield rotations I've done this year (work hard but learn a lot). However, you should get some good unit experience as an intern or second year during residency, so I would not say that a unit rotation is a "must" as a medical student.

On the other hand, if you are up to putting in the hours, it can be a very rewarding experience (procedure-rich, great envoronment for learning normal and abnormal physiology); however, you need to seriously balance this against the need to try to relax during these last few precious months before your life becomes completely consumed with medicine as an intern.

Also, in addition to anesthesia, radiology and cards, don't forget about ortho if you are trying to get some extra experience in EM-related specialties. Generally, a sports medicine elective is usually more laid back than straight ortho and you still get lots of exposure to common ED complaints.

 

[Koko]

See, this is my dilemma. I hear this business about ICU being a must and it is scaring me. We don't have an ICU experience that is very intense here so I have pretty much not done any ICU. I have an elective that I am deciding what to fill with but was thinking more along the lines of cardiology or something. Now this ICU thing is creeping up on me again. An absolute must to have one month of it before graduating? The idea scares me. It is the 2nd to last rotation for me and it doesn't sound fun from what I hear on the forums. Can't I do what BKN suggested and act like there is no such thing as an ICU???

So ICU a must before graduating??? Please say it is not so. BKN... comfort me, say it isn't so!!!

I would not say "a must" before graduation, and that's based on what residents have shared. But, as others have pointed out, it's a high yield rotation for us since you can get quality procedures, familiarity with vents (if not complete mastery ), experience treating very sick and complex patients, great med student conferences, and some increased level of comfort with the critically ill. For me, I would prefer some exposure before I'm an intern and I will also have time for fun before we start up in late June. Believe me, fun was a priority to schedule in before residency starts! Good luck, don't stress, and have fun.

 

[BKN]

See, this is my dilemma. I hear this business about ICU being a must and it is scaring me. We don't have an ICU experience that is very intense here so I have pretty much not done any ICU. I have an elective that I am deciding what to fill with but was thinking more along the lines of cardiology or something. Now this ICU thing is creeping up on me again. An absolute must to have one month of it before graduating? The idea scares me. It is the 2nd to last rotation for me and it doesn't sound fun from what I hear on the forums. Can't I do what BKN suggested and act like there is no such thing as an ICU???

So ICU a must before graduating??? Please say it is not so. BKN... comfort me, say it isn't so!!!

You don't have to do this before residency, 'cause you're gonna get plenty. ACGME EM residencies require at least 2 months of ICU. Many do much more. For example at my shop: EM1 MICU, SICU, EM2 2 months Trauma and ICU, 1 month PICU.

Why are you not looking forward to this? The sickest patients, the most procedures, the most learning. Embrace the dark side. If you're really a EP, you're gonna love it!

 

[BKN]

Oh yeah, and I got the fun thing checked off. I have 6 months off until I start residency so after interviewing... a month at a hospital in South Africa, a few weeks of appreciating the beauty of the Big 5 on the game reserves, say hi to the family in Turkey, and 2-3 months of working in a rural central american clinic to learn medicine with hands/eyes/ears instead of technology. Zen .

Now that sounds really superior.

 

[alreadylernd]

Thanks for all the advice (I'm actually definitely doing an ICU month and a rads elective in the first half of the year).

 

[kbrown]

my 4th year:

2wks Cardio (EKG reading only, no clinic, no patients)
2wks Optho (fundoscopics and slit lamps)
Peds community clinic (all outpt)
ER away (4 wk)
ER away (4 wk)
Anesthesiology (run from room to room intubating, lines)
Radiology (Peds xray, CXR, abd CT, head CT only)
Family Med Sub I (two wk peds, one wk ob/gyn, one wk medicine)
Research month
Finished March 24th.

nothing hard, but stuff that helped me learn a ton. skills that i will need.

 

[trkd]

Why are you not looking forward to this? The sickest patients, the most procedures, the most learning. Embrace the dark side. If you're really a EP, you're gonna love it!

Not sure why I'm not looking forward to it to be quite honest. I guess this is the first thread that I have ever heard something good about it. The others all complain about the hours and how much it sucks.

Hey alreadylernd, you could always go abroad. We'll hook you up with some medical education in the outback (Australia that is). You can spend your weekends somewhere nice while still learning something during the week. For example, dermatology here is known worldwide because this is melanoma-land. Sounds super high-yield to me! But that is just coming from someone in the same position as you. Good luck!

 

[crewmaster1]

TRKD-When and where will you be in South Africa? I am headed there too...to Johannesburg for a month in Trauma Surgery (Feb 15-March 15), should be sweet. From my reading it should cover some of that ICU stuff. What are you doing there?

 

[trkd]

TRKD-When and where will you be in South Africa? I am headed there too...to Johannesburg for a month in Trauma Surgery (Feb 15-March 15), should be sweet. From my reading it should cover some of that ICU stuff. What are you doing there?

Crewmaster, I will PM you.