Is 4th year really that great?

[LLCoolK]

I guess I'm confused to how 4th year works. People keep saying it's going to be "the most expensive vacation you ever take," but don't you still have to take electives? And on top of all that you need to find LORs and finalize your residency applications. Can you really just do nothing during your electives and go to France?

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[Hangry]

Most schools give months of dedicated time off (which can be used as you desire, but are designed to give you time to travel for interview, study for CK/CS, etc) which are the literal vacations. Then you are taking electives, which can be tailored to your interests, and which oftentimes have fairly cush schedules compared to many 3rd year rotations making them feel like vacations. Grades don't really matter for your electives, so the pressure to study during your off time is decreased, taking that much of an edge off all your non sub-I/field of interest rotations.

Is fourth year all vacation? Absolutely not. Depending on your field of interest, you need to do well in Sub-Is, lock in LORs, travel for stressful interviews, pass the last few board exams of medical school, make a rank list of where you want to spend the next years of your life, and match. However, after you've done all that, you can pretty much coast on all your other rotations. Also, the easiest part of fourth year is the last part, so when people look back on fourth year, that time is what is freshest in their memory leading to a lot of the rose colored glasses people can wear when looking back on fourth year. Is it the best year of medical school? Probably. But that doesn't mean it doesn't have its own rough patches.

 

[URHere]

Summer: Brutal yet oddly satisfying to feel competent for once. Constant Sub-Is and high-stress, long-hour rotations.

Winter: Variable depending on how much (or how little) you enjoy interviewing. Minimal clinical responsibilities, and you'll be surprised how little effort you can put in when people are impressed that you even showed up. Honors flow like water. Very expensive. A lot of pre-match stress.

Spring: Mostly lax electives. Some degree of going stir-crazy while waiting for the match and second-guessing everything you know about yourself and what you want from residency. Vacation can be thrown in if you haven't somehow already gone way into the red during interview season.

Overall, more free time, less clerkship-based stress, and significantly more freaking out about money and the future. Then again, I'm still waiting for the blissful post-match period.

 

[atomi]

Nope, it's purgatory.

 

[tiedyeddog]

It's pretty sweet

 

[Psai]

I care very little about what people think

 

[Norris Morris]

4th year feels like a tale of two cities. First half was indeed busy with CK, three sub-I's in a row with an away, etc. Then interviews come and the travel and small talk and "what other questions do you have for me" grows old very fast. Now? Interviews done, and BS electives with no responsibilities just coming in a few days a week. This is the promised land.

 

[mcloaf]

Sure as **** can't suck as much as M3 does.

 

[AlmostAnMD]

Front loaded my schedule fourth year.

Recently, been pulling 80 hr weeks

80 hours on fallout 4, that is. Also about 3 hrs a day M-F of radiology

 

[Snoopy2006]

If you have to ask the question, you're not doing it right.

 

[asdf123g]

what is sub I?

 

[Nymphicus]

It's great.
Something I noticed is that I ask way more questions, and even mildly/politely interrupt to get my question/thought in. Something I would never never never have even thought about a year ago.

Because now I don't care what they think or what the evaluation is, but I want to be competent next year.

 

[OverlyRomantic]

what is sub I?

Stands for Sub Internship. It's an audition rotation where you have the responsibilities of an intern: https://en.m.wikipedia.org/wiki/Sub-internship

 

[Vandelay Industries]

Introduced myself to the fellows on the consult service I'm with this week on Monday. They all seemed to stare off into space with this faint smile followed by comments like "Man, I miss fourth year". The same fellows routinely cut me loose at 1pm.

 

[HooliganSnail]

The more accurate statement is , "4th year is awesome after the Match"

Best period of your life. No one expects anything from you, you have already matched. NO pressure. NO anxiety about your future. You just show up, go home, drink beer, go to baseball games, whatever you want man.

Make sure you take the easiest rotations you can in that period. Ones that require very little time, and NO weekends. Every hospital has those. Mine was plastic surgery. Breeze, saw some cool surgeries in the AM, home by 1 pm. Radi-holiday is always a plus, that was like 9 am to 11 am.

DO NOT DO ICU OR SOMETHING HARD TO "PREPARE" YOU FOR RESIDENCY

That is just stupid.

 

[Psai]

The more accurate statement is , "4th year is awesome after the Match"

Best period of your life. No one expects anything from you, you have already matched. NO pressure. NO anxiety about your future. You just show up, go home, drink beer, go to baseball games, whatever you want man.

Make sure you take the easiest rotations you can in that period. Ones that require very little time, and NO weekends. Every hospital has those. Mine was plastic surgery. Breeze, saw some cool surgeries in the AM, home by 1 pm. Radi-holiday is always a plus, that was like 9 am to 11 am.

DO NOT DO ICU OR SOMETHING HARD TO "PREPARE" YOU FOR RESIDENCY

That is just stupid.

Lol I actually considered signing up for sicu last year for my 2nd semester of 4th year and my friend dissuaded me. Good friend, he really had my back

 

[Law2Doc]

Stands for Sub Internship. It's an audition rotation where you have the responsibilities of an intern: https://en.m.wikipedia.org/wiki/Sub-internship

It's not per se an audition. Many schools make you do these even though you have no intention of spplying to that school or specialty. But yeah, it lets you get the flavor of intern year in a semi-supervised format-- being up all night putting out fires, getting paged by the nurses, etc. intern year is a steep learning curve and this kind of thing helps people from some programs hit the ground running.

There are two schools of thought for fourth year -- you can get all your graduation requirements out of the way early and basically be essentially "done" after the match. Or you can use it as an opportunity to take elective rotations you have an interest in or think might help you down the road . Most will do some version of the former.

But depending on the field you are going into there can be some benefit to having learned a few more things (particularly basic procedural things) before you start. Either way, you'll have already matched and so grades won't matter, attending evaluations of you won't matter (although they tend to like you better because they know you chose to be there voluntarily) -- it's all a matter of your own personal goals and interests. And that makes for a good (half a) year.

 

[Law2Doc]

...
Make sure you take the easiest rotations you can in that period. Ones that require very little time, and NO weekends. Every hospital has those. Mine was plastic surgery. Breeze, saw some cool surgeries in the AM, home by 1 pm. Radi-holiday is always a plus, that was like 9 am to 11 am.

DO NOT DO ICU OR SOMETHING HARD TO "PREPARE" YOU FOR RESIDENCY

That is just stupid.

LOL. In another thread you just suggested you were very proactive/aggressive about maximizing learning opportunities during third year, but that it was your rotations shortcomings that shortchanged you..,

I'm not advocating creating a hard fourth year if you don't want to. It's an elective time -- do what rocks your boat. But frankly those who have done challenging but useful rotations sometimes consider it a beneficial lead in to what they'll be doing next. So it depends on the person and the path. To suggest that others choices are "stupid" is a bit pot meet kettle.

 

[HooliganSnail]

LOL. In another thread you just suggested you were very proactive/aggressive about maximizing learning opportunities during third year, but that it was your rotations shortcomings that shortchanged you..,

I'm not advocating creating a hard fourth year if you don't want to. It's an elective time -- do what rocks your boat. But frankly those who have done challenging but useful rotations sometimes consider it a beneficial lead in to what they'll be doing next. So it depends on the person and the path. To suggest that others choices are "stupid" is a bit pot meet kettle.

No No No No No.

No med student rotation can prepare you for internship, because in internship you will be asked to do things you have never done before. You will need to move patients within a system, to transfer, to facilitate things getting done. No extra ICU rotation at the end of 4th year will help with that. You are better served to take the time off and relax.

All rotations should ideally be either one of two ways

1. Worthwile - the rotation that truly advances your understanding of medicine and takes you to a new level. This will likely require a lot of time and work and effort, but it's totally worth it.

2. Vacation - little time, little hours required to be at hospital. A breeze. Probably won't learn a dam thing, but who cares, because time off is equally important to being a good functioning not-burnt out doctor

Unfortunatly, a TON of rotations ( resident, and med student), are in the middle

May learn a few things, but really not that much. No real patient care responsibilities, mostly just a progress note mule( or nothing), but spend a ridiculous amount of time at the hospital doing nothing worthwhile but you can't go home........WORST ROTATIONS.

 

[Law2Doc]

...
No med student rotation can prepare you for internship, because in internship you will be asked to do things you have never done before...

Some things you will have never done before. Some things you could have done before if you used your elective time more wisely.

 

[mimelim]

The more accurate statement is , "4th year is awesome after the Match"

Best period of your life. No one expects anything from you, you have already matched. NO pressure. NO anxiety about your future. You just show up, go home, drink beer, go to baseball games, whatever you want man.

Make sure you take the easiest rotations you can in that period. Ones that require very little time, and NO weekends. Every hospital has those. Mine was plastic surgery. Breeze, saw some cool surgeries in the AM, home by 1 pm. Radi-holiday is always a plus, that was like 9 am to 11 am.

DO NOT DO ICU OR SOMETHING HARD TO "PREPARE" YOU FOR RESIDENCY

That is just stupid.

No No No No No.

No med student rotation can prepare you for internship, because in internship you will be asked to do things you have never done before. You will need to move patients within a system, to transfer, to facilitate things getting done. No extra ICU rotation at the end of 4th year will help with that. You are better served to take the time off and relax.

All rotations should ideally be either one of two ways

1. Worthwile - the rotation that truly advances your understanding of medicine and takes you to a new level. This will likely require a lot of time and work and effort, but it's totally worth it.

2. Vacation - little time, little hours required to be at hospital. A breeze. Probably won't learn a dam thing, but who cares, because time off is equally important to being a good functioning not-burnt out doctor

Unfortunatly, a TON of rotations ( resident, and med student), are in the middle

May learn a few things, but really not that much. No real patient care responsibilities, mostly just a progress note mule( or nothing), but spend a ridiculous amount of time at the hospital doing nothing worthwhile but you can't go home........WORST ROTATIONS.

I too am having a hard time rationalizing, "I'm the most proactive/assertive person on SDN" with this post. You claim that your MS3 was a complete and total waste of time and you got next to nothing out of it and then you advocate goofing off and minimizing time learning during MS4.

The amount of learning that I did during MS4 was quite amazing. I also certainly acquired a lot of skills that greatly accelerated my intern year and residency. From a procedural standpoint, I placed a lot of central lines and did a bevity of other small procedures. From a functional standpoint, there were rotations where I carried the team pager and handled the floor work in the same way that I did as an intern. Granted everything I did needed to be co-signed by a fellow, but I was treated on service like the prelim intern that was on. It isn't 'much', but I wrote probably 70-80 H&Ps/consult notes, saw half of those consults on my own. That experience certainly helped me be a better intern, which translated into me progressing quickly, which definitely left very favorable impressions with faculty and residents which of course has immense benefits for future training.

To be frank, you sound like you went to a new or poorly run medical school and your residency is poorly run/not optimized. This is obviously not helped by the fact that you under some delusions of grandeur.

 

[iamdoctorji]

This reminds me of my college days....

 

[cbrons]

Front loaded my schedule fourth year.

Recently, been pulling 80 hr weeks

80 hours on fallout 4, that is. Also about 3 hrs a day M-F of radiology

That sounds amazing

 

[HooliganSnail]

I too am having a hard time rationalizing, "I'm the most proactive/assertive person on SDN" with this post. You claim that your MS3 was a complete and total waste of time and you got next to nothing out of it and then you advocate goofing off and minimizing time learning during MS4.

The amount of learning that I did during MS4 was quite amazing. I also certainly acquired a lot of skills that greatly accelerated my intern year and residency. From a procedural standpoint, I placed a lot of central lines and did a bevity of other small procedures. From a functional standpoint, there were rotations where I carried the team pager and handled the floor work in the same way that I did as an intern. Granted everything I did needed to be co-signed by a fellow, but I was treated on service like the prelim intern that was on. It isn't 'much', but I wrote probably 70-80 H&Ps/consult notes, saw half of those consults on my own. That experience certainly helped me be a better intern, which translated into me progressing quickly, which definitely left very favorable impressions with faculty and residents which of course has immense benefits for future training.

To be frank, you sound like you went to a new or poorly run medical school and your residency is poorly run/not optimized. This is obviously not helped by the fact that you under some delusions of .

First Off,

I think we both fundamentally value different things.

I am an ER doctor, so I fundamentally hate certain things ( ie. the 70-80 H&P's you did sounds absolutely miserable). I don't like to round, I don't like to write progress notes, I absolutely hate standing around doing nothing while at work ( waiting for the attending to round). If I am going to stand around, I would rather be at home. I like to show up, do my work, do it well, and then GO HOME.

I love ER medicine. It is fast paced, I get to do cool things, I get to stick large needles in people. I occasionally get to save someones life. Mainly I just see a lot of patients with a lot of different problems. No rounding, just quick chat with the attending and on to the next thing.

Medicine is largely self taught, and primarily gained through experience. The true nature of medical school is that you have to act like everything is worthwhile and "I'm so glad I have this learning opportunity", when really it is wildly expensive and inefficient.

When I started MS-3, I was so excited to actually see patients and really learn what it was like to be a doctor. I quickly learned what being a med student is about, taking abuse, and doing nothing. So after a year of that nonsense, half a year auditioning and interviewing and securing a residency ( O btw I am in an amazing program, thanks for that insult, your a jerk), and finally matching after all the work, abuse, anxiety, seemingly complete lack of control of the rest of your life, I was ready to do very little, and slack off.

My advice is therefore the same. Enjoy your last, easy, stress free months of medical school. Make sure you get out early. Go to the beach. Drink beer. Get a tee time.

Work upon work is waiting for you in residency. You really won't be behind if you don't do extra hard rotations.

 

[Snoopy2006]

Look, M4 year is about a balance. The very early part will obviously be work: aways/sub-I's. Interview season can be fun, or stressful if you want it to be. For me, I had fun from October on, not just fun after Match Day. It varies from school to school, but we knew what the "right" M4 rotations to take were.

On the flip side, I disagree with some of the above advice. I did a MICU month, and it was a godsend for me. That's where I truly learned vent management for the first time, got a ton of procedural experience, etc. Admittedly, I was one med student among 8 amazing residents and they all focused on teaching me. I got to do a week of night's with just me and the intern (the senior would sleep), and my intern would have me create a plan for every RN question, every ABG result, before he would implement his own plan. When **** went south in 2-3 different rooms at once, I was the only non-RN in the room at times. Grew some hair on my chest, and I can't imagine knowing what to do on my intern year ICU rotation (or on codes) without that critical rotation. But I was surrounded by truly phenomenal residents and attendings who were focused on my educational experience and me getting as much hands-on experience as possible. Admittedly many ICU rotations won't be that strong.

It's just a balance. Mix useful rotations with cake ones. My M4 year was even easier than some of the ones mentioned above. Out by 1 pm? We had rotations where showing up 1 out of 4 weeks was considered an achievement. But the ICU rotation was one of the smartest decisions I made in medical school. To each his own.

 

[VisionaryTics]

I did rotations in trauma, burn, and SICU as an M4 going into ENT. Most useful three months of med school. Yeah, I don't put in lines any more or manage drips. But I know how to thoughtfully adminster fluids, recognize a sick patient, evaluate and treat acute and chronic wounds, and choose enteral feeding regimens (beyond Glucerna for diabetics, Nepro for AKI/CKD). Invaluable skills that most interns/residents don't have.

 

[Chemdude]

I too am having a hard time rationalizing, "I'm the most proactive/assertive person on SDN" with this post. You claim that your MS3 was a complete and total waste of time and you got next to nothing out of it and then you advocate goofing off and minimizing time learning during MS4.

The amount of learning that I did during MS4 was quite amazing. I also certainly acquired a lot of skills that greatly accelerated my intern year and residency. From a procedural standpoint, I placed a lot of central lines and did a bevity of other small procedures. From a functional standpoint, there were rotations where I carried the team pager and handled the floor work in the same way that I did as an intern. Granted everything I did needed to be co-signed by a fellow, but I was treated on service like the prelim intern that was on. It isn't 'much', but I wrote probably 70-80 H&Ps/consult notes, saw half of those consults on my own. That experience certainly helped me be a better intern, which translated into me progressing quickly, which definitely left very favorable impressions with faculty and residents which of course has immense benefits for future training.

To be frank, you sound like you went to a new or poorly run medical school and your residency is poorly run/not optimized. This is obviously not helped by the fact that you under some delusions of grandeur.

Just because you wanted to be a gunner in 4th year so you can "progress quickly" in your residency training doesn't mean everyone else has to feel the same way. There are people who want to chill, relax and spend time with their family and friends. There is nothing wrong with that.

 

[Wordead]

Just because you wanted to be a gunner in 4th year so you can "progress quickly" in your residency training doesn't mean everyone else has to feel the same way. There are people who want to chill, relax and spend time with their family and friends. There is nothing wrong with that.

Nothing wrong with being mediocre I guess. Not like you'll have to make decisions that can kill people or anything.

 

[Chemdude]

Nothing wrong with being mediocre I guess. Not like you'll have to make decisions that can kill people or anything.

Huh? People that want to chill and relax in 4th year become mediocre doctors? That's a ridiculous assumption. Please tell me how my performance in 4th year electives will affect my abilities as a future radiologist. 4th year is nothing more than a checklist of required rotations/electives. Get off your high horse.

 

[Chemdude]

OP, one of the greatest things about 4th year is that you stop caring about what other people think of you. You finally have the balls to say "respectfully, I disagree" to a resident or an attending without having to worry about them sabotaging your subjective evals.

 

[Rumalum]

I did my AI's and step 2 very early, leaving the only hard month left the interview month. finished interviews middle of december, and since then I have been able to do nothing except read what I want to read, leave the hospital when I feel like it, and have a normal sleep wake cycle. For my last elective block, I'm doing an independent project where I read some textbook chapters and take notes (I have already done this) so actually I'm going to Mauritius for 3 weeks

 

[Wordead]

Huh? People that want to chill and relax in 4th year become mediocre doctors? That's a ridiculous assumption. Please tell me how my performance in 4th year electives will affect my abilities as a future radiologist. 4th year is nothing more than a checklist of required rotations/electives. Get off your high horse.

Don't worry, you'll see next year when your do your prelim year and are regarded as a general waste of space by the IM residents.

 

[Chemdude]

Don't worry, you'll see next year when your do your prelim year and are regarded as a general waste of space by the IM residents.

I don't give a damn what they think. I'm not becoming an internist. I'm just there to do my work and leave. I'm not there to by anyone's b!tch.

 

[Psai]

I did my AI's and step 2 very early, leaving the only hard month left the interview month. finished interviews middle of december, and since then I have been able to do nothing except read what I want to read, leave the hospital when I feel like it, and have a normal sleep wake cycle. For my last elective block, I'm doing an independent project where I read some textbook chapters and take notes (I have already done this) so actually I'm going to Mauritius for 3 weeks

Sounds nice

 

[URHere]

How hard or easy the end of MS4 should be depends on your personality.

I'm one of those people who tried to take radiology and ended up switching to ICU because I couldn't shake the feeling that I was wasting my time. I'm finishing out MS4 with some weird electives (night shift on ED, ME, public health outbreak investigation, prison medicine), but they'll all be well within the "full-time" range. When I go backpacking around Asia, it'll be a nice break from the grind.

In contrast, many of my classmates are circulating a list of easy electives. That's fine if it works for them, and I appreciate it because it tells me which rotations would probably piss me off. Win/win.

 

[J ROD]

I find ranking programs and trying to decide where to go the next 4 years of my life kinda stressful. Especially with a wife to consider and family too.

 

[J ROD]

Rotations can be as hard or as easy as you want. I did a mix. Gave myself a break after 3 yr and then interviewed and started back with real stuff like my 2 AIs and ED, Peds rotation.

 

[Psai]

I've never watched more tv in my life. I'm sleeping like a beast. My biggest problem is which program I'm going to rank higher. Things are good

 

[DoctorLacrosse]

As a first year I read these posts and find myself gazing off into the distance praying that fourth year comes quickly.

 

[FSUseminoleEM1]

As a first year I read these posts and find myself gazing off into the distance praying that fourth year comes quickly.

It does.

 

[Trefoil]

It's easily the best year. The beginning is quite hectic, but you will likely be doing intense rotations in something you enjoy, which is better than intense rotations in something you hate. The step 2 is not as painful to study for as you would think. It has more clinically relevant information, and it is basically a giant shelf exam. Generally, letter writers are more than happy to write LOR's which makes the process much better than mes school apps which involve professors you have limited contact with. Interviews give you a chance to see different programs and different areas of the country. The end of the year is very low stress other than match. I will say that fourth year is infinitely better than any other year, and you are actually somewhat competent for the first time which sort of makes it all worth it.

 

[WingedOx]

I'm kind of in the middle between the @mimelim/@Wordead and @Chemdude/@HooliganSnail camps, but in all honesty I lean toward the latter group (particularly given Wordead's hyperbole).

The learning curve is so much steeper during intern year compared to anything you've done in med school that going out of your way to cram intense rotations in isn't going to make a huge difference to your life or your ultimate performance. I was so burned out with med school by the time I hit mid-M4 year that relaxing a bit and dedicating some months to non-hospital-related pursuits really helped me reset for residency.

Coming from someone who spent the last couple years intensely monitoring the performance of our interns, everyone enters their internship at somewhat different levels of performance. Just about everyone gets up to speed within the first month or so. If you're still struggling by September, then I start to get concerned, but if you're not up to speed with your peers by that point, you likely needed more than an extra sub-I type rotation anyway.

 

[Wordead]

I'm kind of in the middle between the @mimelim/@Wordead and @Chemdude/@HooliganSnail camps, but in all honesty I lean toward the latter group (particularly given Wordead's hyperbole).

The learning curve is so much steeper during intern year compared to anything you've done in med school that going out of your way to cram intense rotations in isn't going to make a huge difference to your life or your ultimate performance. I was so burned out with med school by the time I hit mid-M4 year that relaxing a bit and dedicating some months to non-hospital-related pursuits really helped me reset for residency.

Coming from someone who spent the last couple years intensely monitoring the performance of our interns, everyone enters their internship at somewhat different levels of performance. Just about everyone gets up to speed within the first month or so. If you're still struggling by September, then I start to get concerned, but if you're not up to speed with your peers by that point, you likely needed more than an extra sub-I type rotation anyway.

Lazy is lazy, it doesn't suddenly change in residency. I never said the entire 4th year should be packed with intense rotations. But wasting a whole year and then thinking you'll turn it up and catch up in residency sounds like some BS magical thinking, much like the preclinical students that think they'll turn it on for step 1 or rotations or whatever.

 

[WingedOx]

Lazy is lazy, it doesn't suddenly change in residency. I never said the entire 4th year should be packed with intense rotations. But wasting a whole year and then thinking you'll turn it up and catch up in residency sounds like some BS magical thinking, much like the preclinical students that think they'll turn it on for step 1 or rotations or whatever.

Who says taking it easy is wasting a year (or lazy, really)? I didn't do a whole lot as an MS4, but I learned a whole lot of things that are still useful to me today on some of those "blow off" rotations.

If you did what you needed to do in 3rd year, there's no reason to go out of your way to lose sleep in 4th. Congratulations on whatever you did or didn't do during MS4, but no one gives a shiat today. Let's not act pompous now.

 

[evilbooyaa]

Lazy is lazy, it doesn't suddenly change in residency. I never said the entire 4th year should be packed with intense rotations. But wasting a whole year and then thinking you'll turn it up and catch up in residency sounds like some BS magical thinking, much like the preclinical students that think they'll turn it on for step 1 or rotations or whatever.

It's called not completely burning yourself out just before the biggest sprint of your life, hours wise. The same way that some people advocate taking a break year between undergrad and medical school, consider the 2nd half of 4th year (it's hard to blow off the ENTIRE year since you'll be doing sub-Is, aways, etc.) after interview season to be the break you have available to recharge before residency.

I took an easy 2nd half of 4th year, and because I was refreshed and re-energized, hit the ground running (somewhat) as an intern. I'm probably not top in my class (as a prelim) but I know for a fact I'm not the worst.

 

[Wordead]

Who says taking it easy is wasting a year (or lazy, really)? I didn't do a whole lot as an MS4, but I learned a whole lot of things that are still useful to me today on some of those "blow off" rotations.

If you did what you needed to do in 3rd year, there's no reason to go out of your way to lose sleep in 4th. Congratulations on whatever you did or didn't do during MS4, but no one gives a shiat today. Let's not act pompous now.

It's called not completely burning yourself out just before the biggest sprint of your life, hours wise. The same way that some people advocate taking a break year between undergrad and medical school, consider the 2nd half of 4th year (it's hard to blow off the ENTIRE year since you'll be doing sub-Is, aways, etc.) after interview season to be the break you have available to recharge before residency.

I took an easy 2nd half of 4th year, and because I was refreshed and re-energized, hit the ground running (somewhat) as an intern. I'm probably not top in my class (as a prelim) but I know for a fact I'm not the worst.

You guys are putting words in my mouth. I'm not saying anyone should take all difficult rotations. But you should make sure you're ready to be an intern. If you're a graduating M4 that has no idea how to manage fluids/lytes, how to work up basic things like tachycardia/low UOP, I would say you screwed up somewhere.

I am probably more concerned about this attitude because I've gotten sign out from night float interns where X happened overnight, and they decided to handle it by doing something nonsensical and when I asked why they had no reasoning to back it up. And yes, there have been a couple times that it ended up seriously injuring patients.

 

[HooliganSnail]

You guys are putting words in my mouth. I'm not saying anyone should take all difficult rotations. But you should make sure you're ready to be an intern. If you're a graduating M4 that has no idea how to manage fluids/lytes, how to work up basic things like tachycardia/low UOP, I would say you screwed up somewhere.

I am probably more concerned about this attitude because I've gotten sign out from night float interns where X happened overnight, and they decided to handle it by doing something nonsensical and when I asked why they had no reasoning to back it up. And yes, there have been a couple times that it ended up seriously injuring patients.

I think that you are confusing stupid with "didn't get enough experience during rotations".

The sad fact is that there a lot of doctors who are just not that clinically astute. They answer questions right, they even write decent notes, but when it comes to making a decision regarding acute management, they're just not that brilliant.

I don't think that if those residents had done more intensive rotations they would be better.