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- Mar 11, 2009
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Having worked at a level 1 trauma center, it is my opinion that they are overrated unless you LOVE orthopaedic/trauma surgery, in which case they are the place to be. Everything else can be gotten in a large level 2 just as easily (like open heart, transplants etc.). Both the level one traumas near me I feel are worse hospitals than the level two trauma I work at now.
The ER will be busy at any downtown hospital, level 1 or not, and internal med is internal med no matter where your at. I think as DO students we will be at the bottom of the bucket (i.e. last in line to be able to do stuff) at most teaching hospitals and basically end up mostly shadowing and doing histories. But at the rural places our opprotunities to do more wil prob be greater.
So I guess what it comes down to when picking a rotation the question is more 'big hospital with more severe cases that I wont get to touch versus small hospital with less severity where I might get more hands on.' There is an educational benefit to both and one must decide if you learn better by seeing or doing.
DOs are doctors. Plain and simple. We are no less than the MDs. As a student (MD or DO) you will be shadowing and doing histories, mostly because we will not be able to write notes for our patient encounters. It used to be that the hospital could still bill for a student note, but now they can't.
That said, you'll still get to do a lot of stuff, but it depends more on your preceptor and what they let you do. Your mileage will vary depending on which preceptors you get and how much they want to show you/let you do.
As for level 1 trauma center, they don't really get 'better' cases. They just get different cases. As someone else said, unless you're really angling to be a trauma surgeon or an orthopod, you will get a better mix at a different hospital.
Fact: a decent chunk of what you see in the ER will be neither emergent nor urgent. People use the ER as primary care. Furhtermore, a decent chunk of what you see will be urgent but not EMERGENT. You'll patch 'em up and send them on their way. The rest will be emergent care, and that will be things that will vary from sepsis patients to cardiac patients to strokes.
You'll see PLENTY of those things at ANY hospital. But if you're all about the gunshot wounds and the bloody car crashes, then level 1 trauma is for you.