VA Hospital/Clinic Rotation experiences

[aphios5]

So, I've looked up older threads on this subject and there isn't a whole bunch of information. Just checking to see if anyone has any new experiences they'd like to share (first or second hand) regarding their rotation experience, good or bad, at the VA. I'm thinking about signing up for this as one of my fourth-year rotations. I come from a military family so there's that. Thanks!

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[styphon]

I did urology at VA as a medical student - I enjoyed it. 99% male patients, most over >50 years old - which is partly due to the field itself. They were very thankful/grateful patients. I wasn't allowed to do much in the procedure room - and did not really go in on major surgeries - but I was very active in the urology outpt clinic.

I had part of my optho rotation there - outpt clinic. Same type of patients...

I had my outpt psych at a VA hospital - tons of PTSD and depression - but the age was younger than the two previous clinics.

 

[Kaustikos]

There are a couple things I've learned from my experience and others at the VA.
First; surgery and anesthesia is a really great experience (well, here anyways) as a medical student because you definitely do more. The attending (by law) only has to be in the room and not necessarily scrubbed in all the time. Most attendings do just that and so it leaves the intern/resident/fellow and the med student. I only had the chance to do Anesthesia and it was VERY similar in that I was allowed to do almost everything outside of titrating/controlling meds. I learned a lot by first hand experience. And I saw other med students being first assist in a lot of procedures.

As far as inpatient/outpatient? I won't comment on my inpatient because I let my subspecialty inpatient experience ruin my motivation/desire to help and it showed so much. I had such a huge distaste for my superiors and didn't care for patients. I, thankfully, turned around near the end and it helped me. It wasn't a bad experience except that med students weren't allowed to write H&P's on the computer and only allowed to do progress notes (weird). That and EMR access is a pain in the ass. That and their security restrictions are damn near annoying because the buildings pretty much wall off cell reception, don't let you use wi-fi and restrict access to certain sites. I get the logic (patient security since they use their SSN) but I found it weird that youtube/facebook was accessible and I couldn't use google drive.
However, I'll say that I seriously LOVE the patients at the VA. They are the most down to earth/funniest people to be with. Yes, some are idiots (ex - the patient who demanded to be allowed to use dip because the laws said nothing about dip, just smoking... never understanding that it was the staff that made the call on the use of this stuff regardless and he was welcome to leave AMA), but they're just different in the sense that I enjoyed talking with them. They didn't hold back when having conversations (telling me anything/everything I needed) and were understanding that their recreational lifestyle (smoking/alcohol) is what brought them here/made them this way. But it's really hard to tell an 85 year old he should quit smoking now considering he's made it this far . Are there drug seekers? Of course... Are there addicts? Yup. But it was still enjoyable not worrying about being candid with them and them loving it.

 

[FutureInternist]

So, I've looked up older threads on this subject and there isn't a whole bunch of information. Just checking to see if anyone has any new experiences they'd like to share (first or second hand) regarding their rotation experience, good or bad, at the VA. I'm thinking about signing up for this as one of my fourth-year rotations. I come from a military family so there's that. Thanks!

Patients are great
Nurses are crap
Attendings are all over the place

If I remember correctly, each residency has to provide interns/residents to the local VA so no matter which specialty you choose, you will end up at a VA so better to get used to the system ahead of time